Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
June 2015 Vol. 4(6), pp. 281-288
Copyright © 2015 Global Advanced Research Journals


Full Length Research Paper

Endothelial cell loss and graft survival after Descemet stripping automated endothelial keratoplasty (DSAEK): 6-year follow-up

Maria L. Salvetat, Marco Zeppieri, Flavia Miani and Paolo Brusini

Department of Ophthalmology, Azienda Ospedaliero-Universitaria “Santa Maria della Misericordia”, Udine, Italy

*Corresponding Author E-mail:; Tel.: +432-552747; Fax: +432-552741

Accepted 29 June, 2015


Purpose: To evaluate graft survival and central endothelial cell density (ECD) loss after Descemet stripping automated endothelial keratoplasty (DSAEK) during a six-year follow-up and to identify factors related with higher postoperative ECD loss. Methods: This prospective, non-comparative, observational case series study included 91 consecutive cases of DSAEK by a surgeon in 80 subjects (mean age 73.6±11.2 years, range 35-95). ECD measurements were available in 52 eyes at 6 months, and 15 eyes of 15 patients at 6 years. Preoperative ECD was obtained from the eye bank charts; postoperative central ECD was assessed using non-contact specular microscope during 6 years. Pre- and post-operative data were compared using paired t-test. Multivariate analysis of variance was used to identify factors associated with donor ECD loss at 6 months postoperatively. Results: Of the 91 eyes undergoing DSAEK procedure, 19.8% of eyes experienced primary graft failure and 5.5% late graft failure. The overall graft survival during a six-year follow-up was 74.7%. The donor ECD progressively decreased after surgery. The mean percentage of ECD loss from before to after surgery increased form 49.9±15.1% 6 months (n=52 eyes) to 72.3±8.8% 6 years postoperatively (n=15 eyes). Predictors of the postoperative ECD loss included: donor ECD (p=0.02); donor endothelial cell polymorphism degree (p=0.004); and donor death-to-use time (p=0.02).

Keywords: Descemet stripping automated endothelial keratoplasty (DSAEK), non-contact specular microscopy; graft survival, central endothelial cell density, corneal graft.


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