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Cornea:
doi: 10.1097/ICO.0b013e3182a7389c
Clinical Science

Descemet Stripping Endothelial Keratoplasty for the Treatment of Combined Fuchs Corneal Endothelial Dystrophy and Keratoconus

Vira, Samir MD*; Abugo, Usiwoma MD*; Shih, Carolyn Y. MD, MBA, MPH†,‡; Udell, Ira J. MD†,‡; Sperling, Brian§; Hannush, Sadeer B. MD§; Basti, Surendra MD; Bouchard, Charles S. MD*

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Abstract

Purpose:

To report the first case series of patients with Fuchs corneal endothelial dystrophy (FCD) and keratoconus (KCN) who underwent Descemet stripping endothelial keratoplasty (DSEK).

Methods:

This is a retrospective case series of 6 eyes of 4 patients with combined FCD and KCN who underwent DSEK at 3 different centers. Clinical information collected included corneal topography measurements, central corneal thickness, and endothelial cell count. Visual outcomes and change in keratometric measurements were evaluated.

Results:

The follow-up for patients ranged from 10 to 72 months. The best-corrected visual acuity was 20/40 or better in all 6 eyes. The mean keratometric measurements decreased in all cases (range of 0.5–5.8 diopters); however, topography still demonstrated an inferior steepening in each case.

Conclusions:

Patients with FCD and KCN have been previously reported as being managed with penetrating keratoplasty. We present 6 eyes of 4 patients who were managed with DSEK for the FCD. Topographically, the characteristic inferior steepening of KCN did not change; however, all patients with DSEK had flatter postoperative keratometric measurements with improved visual acuity. If a DSEK is performed for FCD before apical corneal scarring from KCN, a good visual outcome may be achieved.

Copyright © 2013 by Lippincott Williams & Wilkins

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