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Cornea and External Disease

Long-term follow-up confirms durability of Descemet stripping only

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Results from a recent retrospective study including 26 eyes of 20 patients undergoing Descemet stripping only (DSO) between December 2015 and November 2022 demonstrated the durability of DSO, with up to 7 years follow up in some cases.

The study included participants with peripheral endothelial cell count (ECC) >1000 cells/mm2 and symptoms caused by central guttata who underwent a central circular 4-mm descemetorhexis using a reverse Sinskey hook and a pair of descemetorhexis forceps with a peeling technique. Best-corrected visual acuity (BCVA), central corneal thickness (CCT), and ECC measured centrally and at the periphery were measured before surgery and at last follow-up. The mean age was 73 ± 9 years, and the follow-up period was 23.7 ± 24.8 months.

Twenty-two eyes responded to DSO with 20 female eyes (91%) and 2 male eyes (9%). The mean postoperative BCVA improved from 0.3 ± 0.17 logMAR to 0.09 ± 0.13 logMAR. The mean postop CCT decreased from 588 ± 41 μm to 546 ± 50 μm, while the mean postop central ECC was 780 ± 257 cells/mm2 [484-1500]. Peripheral ECC decreased postop (1837 ± 407 cells/mm2 preop to 864 ± 340 cells/mm2 postop). Peripheral endothelial cell polymegathism was stable while the average peripheral endothelial cells polymorphism decreased postoperatively (63.1 ± 20.5% preop to 33% ± 25% postop).

Four eyes without improvement after DSO underwent Descemet membrane endothelial keratoplasty surgery. The preoperative trend was for nonresponders to have lower BCVA, higher CCT, more abnormal peripheral polymorphism, and polymegathism, the researchers noted.

Reference:
Rizk M, Dubois M, Elahi S, et al. Long-term follow-up of descemet stripping only: Data up to 7 years postoperatively. Cornea. Published online Dec 26, 2023. doi:10.1097/ICO.0000000000003449

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