DSEK: 10 Year Endothelial Cell Loss Compared with Full Thickness Transplants

Descemet Stripping Endothelial Keratoplasty (DSEK) was the first method of partial thickess transplant to become widely adopted. Dr. Francis Price performed the first DSEK in the USA in 2003 and helped refine and popularize the procedure. Since that time, through the Cornea Transplant Database and countless man-hours of patient follow-up by our dedicated research staff, we have collected outcomes nearly 2,000 DSEK procedures.

We reviewed our first 1,005 consecutive DSEK procedures by 6 surgeons identified 752 transplants (75%) in 590 recipients with endothelial cell measurements taken at one or more post-operative exams between 6 months and 10 years. These DSEK recipients were 21 to 96 years of age and were treated for Fuchs' dystrophy (84%), corneal edema (15%) or other endothelial dysfunction requiring a transplant (1%).

Endothelial cell measurements are an important part of a comprehensive eye exam because they provide insight about the health of the graft. High numbers of cells indicate the graft is doing well, whereas if there is a drop in cell count from one exam to the next, we know that the graft isn't doing as well as it once was which can indicate a decline in visual performance.

We compared our 10-year DSEK findings to that of full-thickness (Penetrating Keratoplasty, KL) transplant recipients. Using statistical models previously used to evaluate PK outcomes in the Cornea Donor Study, we found that at 10 years cell loss was comparable in surviving clear grafts for both DSEK and PK. Learn more about these findings here. Simultaneously we have been gathering data on our 5-year DMEK outcomes and will share those findings soon!

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