Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India
Purpose: To analyze the visual outcome and complications of Descemet stripping endothelial keratoplasty (DSEK) with their management in 256 eyes at a tertiary eye care center in southern India. Methods: This is a retrospective interventional study of 62 months duration conducted at a tertiary eye...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=1862;epage=1867;aulast=Kodavoor |
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| author | Shreesha Kumar Kodavoor Komal B Patekar Dandapani Ramamoorthy |
| author_facet | Shreesha Kumar Kodavoor Komal B Patekar Dandapani Ramamoorthy |
| author_sort | Shreesha Kumar Kodavoor |
| collection | DOAJ |
| description | Purpose: To analyze the visual outcome and complications of Descemet stripping endothelial keratoplasty (DSEK) with their management in 256 eyes at a tertiary eye care center in southern India. Methods: This is a retrospective interventional study of 62 months duration conducted at a tertiary eye care center in southern India. Two hundred and fifty-six eyes of 205 patients were included in the study after obtaining written informed consent from the patients. All cases of DSEK were performed by a single experienced surgeon. In all cases, donor dissection was performed manually. A Sheet's glide was inserted through the temporal corneal incision and donor button was placed on the Sheet's glide with the endothelial side down. The lenticule was separated and inserted into the anterior chamber by pushing the lenticule into the anterior chamber using Sinskey's hook. Any complication, either intraoperative or postoperative, was recorded and managed either medically or by appropriate surgical means. Results: The mean best corrected visual acuity (BCVA) before surgery was CF-1 m, which improved to 6/18 after surgery. Intraoperative donor graft perforation during dissection was seen in 12 cases, thin lenticule in three eyes, and repeated artificial Anterior Chamber (AC) collapse in three eyes. Dislocation of lenticule was the most common complication seen in 21 eyes, which was managed by graft repositioning and rebubbling. Eleven cases had minimal separation of the graft and seven cases had interface haze. Pupillary block glaucoma was seen in two cases that resolved with partial release of bubble. Surface infiltrate was seen in two cases, which was managed with topical antimicrobial agents. Primary graft failure was seen in two cases. Conclusion: DSEK is a promising alternative to penetrating keratoplasty for corneal endothelial decompensation, but it also has its own merits and limitations, and most often, merits overweigh limitations. |
| first_indexed | 2024-03-12T22:31:09Z |
| format | Article |
| id | doaj.art-feda459685e34f45ae382409f98f7cdf |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-03-12T22:31:09Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-feda459685e34f45ae382409f98f7cdf2023-07-21T15:14:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892023-01-017151862186710.4103/IJO.IJO_2588_22Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern IndiaShreesha Kumar KodavoorKomal B PatekarDandapani RamamoorthyPurpose: To analyze the visual outcome and complications of Descemet stripping endothelial keratoplasty (DSEK) with their management in 256 eyes at a tertiary eye care center in southern India. Methods: This is a retrospective interventional study of 62 months duration conducted at a tertiary eye care center in southern India. Two hundred and fifty-six eyes of 205 patients were included in the study after obtaining written informed consent from the patients. All cases of DSEK were performed by a single experienced surgeon. In all cases, donor dissection was performed manually. A Sheet's glide was inserted through the temporal corneal incision and donor button was placed on the Sheet's glide with the endothelial side down. The lenticule was separated and inserted into the anterior chamber by pushing the lenticule into the anterior chamber using Sinskey's hook. Any complication, either intraoperative or postoperative, was recorded and managed either medically or by appropriate surgical means. Results: The mean best corrected visual acuity (BCVA) before surgery was CF-1 m, which improved to 6/18 after surgery. Intraoperative donor graft perforation during dissection was seen in 12 cases, thin lenticule in three eyes, and repeated artificial Anterior Chamber (AC) collapse in three eyes. Dislocation of lenticule was the most common complication seen in 21 eyes, which was managed by graft repositioning and rebubbling. Eleven cases had minimal separation of the graft and seven cases had interface haze. Pupillary block glaucoma was seen in two cases that resolved with partial release of bubble. Surface infiltrate was seen in two cases, which was managed with topical antimicrobial agents. Primary graft failure was seen in two cases. Conclusion: DSEK is a promising alternative to penetrating keratoplasty for corneal endothelial decompensation, but it also has its own merits and limitations, and most often, merits overweigh limitations.http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=1862;epage=1867;aulast=Kodavoordsekendothelial keratoplastyfuch's endothelial corneal dystrophy |
| spellingShingle | Shreesha Kumar Kodavoor Komal B Patekar Dandapani Ramamoorthy Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India Indian Journal of Ophthalmology dsek endothelial keratoplasty fuch's endothelial corneal dystrophy |
| title | Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India |
| title_full | Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India |
| title_fullStr | Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India |
| title_full_unstemmed | Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India |
| title_short | Complications of Descemet stripping endothelial keratoplasty – A retrospective interventional study at a tertiary eye care center in Southern India |
| title_sort | complications of descemet stripping endothelial keratoplasty a retrospective interventional study at a tertiary eye care center in southern india |
| topic | dsek endothelial keratoplasty fuch's endothelial corneal dystrophy |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=1862;epage=1867;aulast=Kodavoor |
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