PURPOSE: To characterize the clinical and histologic features of primary graft failure after Descemet's stripping and automated endothelial keratoplasty (DSAEK). DESIGN: Retrospective observational case series. PARTICIPANTS: Sixteen cases of DSAEK graft failure from 15 patients, all with detailed histologic examination of failed graft tissue. METHODS: Hematoxylin-eosin, periodic acid-Schiff staining, and light microscopy were used to examine the failed DSAEK graft tissue from all patients. MAIN OUTCOME MEASURES: Examination of specimens for corneal endothelial cell viability and host-donor interface characteristics. RESULTS: Clinical history revealed that 88% (14/16) of studied DSAEK grafts detached before failure, and pathologic examination found that 75% (12/16) of failed grafts had atrophic corneal endothelium. Examples of residual host Descemet's membrane in the graft site and improper donor trephination were also identified. CONCLUSIONS: Marked loss of the corneal endothelium is the prominent feature of primary DSAEK graft failure. Examples of surgical features, such as incomplete Descemet's stripping and residual full-thickness cornea with a DSAEK graft, are shown.
PURPOSE: To characterize the clinical and histologic features of primary graft failure after Descemet's stripping and automated endothelial keratoplasty (DSAEK). DESIGN: Retrospective observational case series. PARTICIPANTS: Sixteen cases of DSAEK graft failure from 15 patients, all with detailed histologic examination of failed graft tissue. METHODS:Hematoxylin-eosin, periodic acid-Schiff staining, and light microscopy were used to examine the failed DSAEK graft tissue from all patients. MAIN OUTCOME MEASURES: Examination of specimens for corneal endothelial cell viability and host-donor interface characteristics. RESULTS: Clinical history revealed that 88% (14/16) of studied DSAEK grafts detached before failure, and pathologic examination found that 75% (12/16) of failed grafts had atrophic corneal endothelium. Examples of residual host Descemet's membrane in the graft site and improper donor trephination were also identified. CONCLUSIONS: Marked loss of the corneal endothelium is the prominent feature of primary DSAEK graft failure. Examples of surgical features, such as incomplete Descemet's stripping and residual full-thickness cornea with a DSAEK graft, are shown.
Authors: Bryan S Lee; Ajoy S Virdi; Kristin M Hammersmith; Albert S Jun Journal: Graefes Arch Clin Exp Ophthalmol Date: 2010-05-12 Impact factor: 3.117
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Authors: S Heinzelmann; P Maier; D Böhringer; C Auw-Hädrich; T Reinhard Journal: Graefes Arch Clin Exp Ophthalmol Date: 2013-05-10 Impact factor: 3.117
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