Outcome of Descemet Stripping Automated Endothelial Keratoplasty in Failed Penetrating Keratoplasty

PURPOSE: The purpose of this study was to report the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) surgeries in eyes with failed penetrating keratoplasty (PKP). METHODS: This was a retrospective, noncomparative, descriptive case series. Patients who underwent DSAEK following PKP from January 2007 to December 2012 were reviewed. Data were collected on best-corrected visual acuity (BCVA) before and 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years following DSAEK. Intra- and post-operative complications, changes in intraocular pressure (IOP) were also documented. Demographics were associated with the visual outcomes. RESULTS: Fifteen eyes of 15 patients with failed PKP comprised the study group. BCVA improved by 2 or more lines at 6 months after DSAEK in ten (66.6%) eyes. In the five eyes that did not experience an increase in BCVA, four had complications; detached lenticule (2 eyes), rejection (1 eye), and dislocation of the graft (1 eye). One eye had ocular comorbidity causing poor vision. The mean IOP at 12–15 weeks postoperatively was 17.4 ± 6.8 mmHg. CONCLUSION: DSAEK for failed PKP resulted in improved vision in two-third of cases. Selection of cases for this repeat surgery seems to be a key in successful outcomes.