PURPOSE: Our aim was to evaluate the surgical technique and postoperative results of Descemet stripping automated endothelial keratoplasty (DSAEK) for bullous keratopathy in eyes with microcornea. METHODS: Two patients with microcornea (8.8 mm in case 1 and 9.3 mm in case 2) and bullous keratopathy after cataract surgery or after laser iridotomy were treated by DSAEK. A donor lamella with a smaller diameter (7.5 mm) was inserted into the anterior chamber using the double-glide donor insertion technique (Busin glide with intraocular lens sheet glide). RESULTS: No intraoperative or postoperative complications occurred. Corrected visual acuity improved from counting fingers to 0.222 logMAR in case 1 and from 1.000 to 0.155 logMAR in case 2 over 6 months. Corneal endothelial cell loss was 6.5 % in case 1 and 1.9 % in case 2. CONCLUSIONS: DSAEK was useful for bullous keratopathy in patients with microcornea. However, surgery should be done with meticulous care, and modification of the diameter of the donor lamella and of the donor insertion technique may be required.
PURPOSE: Our aim was to evaluate the surgical technique and postoperative results of Descemet stripping automated endothelial keratoplasty (DSAEK) for bullous keratopathy in eyes with microcornea. METHODS: Two patients with microcornea (8.8 mm in case 1 and 9.3 mm in case 2) and bullous keratopathy after cataract surgery or after laser iridotomy were treated by DSAEK. A donor lamella with a smaller diameter (7.5 mm) was inserted into the anterior chamber using the double-glide donor insertion technique (Busin glide with intraocular lens sheet glide). RESULTS: No intraoperative or postoperative complications occurred. Corrected visual acuity improved from counting fingers to 0.222 logMAR in case 1 and from 1.000 to 0.155 logMAR in case 2 over 6 months. Corneal endothelial cell loss was 6.5 % in case 1 and 1.9 % in case 2. CONCLUSIONS: DSAEK was useful for bullous keratopathy in patients with microcornea. However, surgery should be done with meticulous care, and modification of the diameter of the donor lamella and of the donor insertion technique may be required.
Authors: Mark A Terry; Neda Shamie; Edwin S Chen; Paul M Phillips; Karen L Hoar; Daniel J Friend Journal: Ophthalmology Date: 2008-12-16 Impact factor: 12.079