Clinical Outcomes of Nanothin Descemet Stripping Automated Endothelial Keratoplasty in Korean Patients with Corneal Endothelial Dysfunction

PURPOSE: To evaluate the clinical outcomes of nanothin Descemet stripping automated endothelial keratoplasty (DSAEK) in Korean patients with corneal endothelial dysfunction. METHODS: We retrospectively reviewed medical records of the patients who underwent nanothin DSAEK (graft thickness ≤50 μm) due to corneal endothelial dysfunction and followed up more than 1 year. We evaluated best-corrected visual acuity (BCVA), central corneal thickness, and corneal endothelial cell density at preoperative and 1, 3, 6, and 12 months postoperatively. RESULTS: Sixteen eyes of 16 patients with the mean follow-up period of 13.00 ± 0.96 months were included. The mean graft thickness after deswelling was 45.25 ± 4.59 μm (range, 38.0–50.0 μm). The mean logarithm of the minimum angle of resolution BCVA improved from 1.37 ± 0.53 preoperatively to 0.68 ± 0.46, 0.55 ± 0.35, 0.40 ± 0.25, and 0.39 ± 0.25 at 1, 3, 6, and 12 months postoperatively (p = 0.005, p < 0.001, p < 0.001, and p < 0.001), respectively. The mean central corneal thickness improved from 752.00 ± 129.11 to 555.75 ± 54.66 μm at 12 months postoperatively (p = 0.006). The mean graft endothelial cell density decreased from 2,859.62 ± 228.34 to 1,542.25 ± 627.34 cells/mm(2) at 12 months postoperatively (p = 0.012). The postoperative complications included increased intraocular pressure (n = 3, 18.75%) and graft dislocation (n = 1, 6.25%), all of which were successfully managed by anterior chamber paracentesis or rebubbling. No other serious complications were encountered. CONCLUSIONS: Nanothin DSAEK produced significant and stable visual improvements without severe postoperative complications in Korean patients with corneal endothelial dysfunction.