You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

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*

doi: 10.1097/ICO.0b013e3182a7389c
Clinical Science

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.

Author Information

*Department of Ophthalmology, Loyola University Medical Center, Maywood, IL;

Department of Ophthalmology, North Shore Long Island Jewish Health System, Bronx, NY;

Albert Einstein College of Medicine, Bronx, NY;

§Cornea Service, Wills Eye Institute, Philadelphia, PA; and

Department of Ophthalmology, Northwestern Memorial Hospital, Chicago, IL.

Reprints: Samir Vira, Department of Ophthalmology, Loyola University Medical Center, 2160 South 1st Avenue, Suite 2601, Maywood, IL 60153 (e-mail:

Author Disclosure Information and Conflicts of Interest: S. Vira, None; U. Abugo None; B. Sperling, None; S.B. Hannush, None; S. Basti, None; C.S. Bouchard CS, None.

Received April 30, 2013

Accepted July 27, 2013

© 2014 by Lippincott Williams & Wilkins.