Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases
PURPOSE: To analyze the complications and their managements in Descemet's stripping endothelial keratoplasty (DSEK) in consecutive 430 cases by single surgeon in a tertiary eye hospital. MATERIALS AND METHODS: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analy...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005239/ https://www.ncbi.nlm.nih.gov/pubmed/24008797 http://dx.doi.org/10.4103/0301-4738.116484 |
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author | Basak, Samar K Basak, Soham |
author_facet | Basak, Samar K Basak, Soham |
author_sort | Basak, Samar K |
collection | PubMed |
description | PURPOSE: To analyze the complications and their managements in Descemet's stripping endothelial keratoplasty (DSEK) in consecutive 430 cases by single surgeon in a tertiary eye hospital. MATERIALS AND METHODS: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ‘Taco’ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months). RESULTS: 13 (3.0%) eyes had operative complications during donor dissection and 16 (3.7%) had during recipient procedure. In 7 (1.6%) eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9%) eyes had donor dislocation and 12 (2.8%) eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3%) eyes had secondary glaucoma and 14 (3.3%) eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2%) cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2%) and in 17 cases re-DSEK was performed successfully. CONCLUSIONS: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience. |
format | Online Article Text |
id | pubmed-4005239 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-40052392014-05-01 Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases Basak, Samar K Basak, Soham Indian J Ophthalmol Original Article PURPOSE: To analyze the complications and their managements in Descemet's stripping endothelial keratoplasty (DSEK) in consecutive 430 cases by single surgeon in a tertiary eye hospital. MATERIALS AND METHODS: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ‘Taco’ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months). RESULTS: 13 (3.0%) eyes had operative complications during donor dissection and 16 (3.7%) had during recipient procedure. In 7 (1.6%) eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9%) eyes had donor dislocation and 12 (2.8%) eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3%) eyes had secondary glaucoma and 14 (3.3%) eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2%) cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2%) and in 17 cases re-DSEK was performed successfully. CONCLUSIONS: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience. Medknow Publications & Media Pvt Ltd 2014-02 /pmc/articles/PMC4005239/ /pubmed/24008797 http://dx.doi.org/10.4103/0301-4738.116484 Text en Copyright: © Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Basak, Samar K Basak, Soham Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title | Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title_full | Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title_fullStr | Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title_full_unstemmed | Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title_short | Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases |
title_sort | complications and management in descemet's stripping endothelial keratoplasty: analysis of consecutive 430 cases |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005239/ https://www.ncbi.nlm.nih.gov/pubmed/24008797 http://dx.doi.org/10.4103/0301-4738.116484 |
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