Purpose: To describe a new technique for donor insertion in cases of Descemet-stripping automated endothelial keratoplasty (DSAEK).
Methods: This is a retrospective case series study of a novel method to introduce the donor tissue in DSAEK. This is a report of 16 cases that underwent the DSAEK procedure. The surgical technique consisted of stripping the Descemet membrane and endothelium from the recipient's central cornea and insertion of a posterior donor tissue with a double-armed 10-0 polypropylene, nonabsorbable suture, with a straight transchamber needle and a 1/2 circle needle. Follow-up was 1-12 months. Best spectacle-corrected visual acuity (BSCVA) was measured at 3, 6, and 12 months, and endothelial counts were measured up to 12 months after the surgery.
Results: Sixteen consecutive patients underwent uncomplicated DSAEK. Three patients had known macular scar or glaucomatous optic nerve damage that precluded results of vision better than 20/200. Of the remaining 13 patients, 3 had BSCVA of 20/70 by the third month postoperative, 9 were 20/50, and 1 achieved 20/40. Nine were 20/40 or better at 1 year and the other 4 achieved 20/50. The average cell count after 1 year was 1950 cells/mm2.
Conclusions: Early outcomes in our initial series of cases of DSAEK using a suture to insert the donor suggest that the technique provides advantages related to endothelial cell loss. DSAEK allows more rapid BSCVA visual recovery than that usually found with penetrating keratoplasty.