To evaluate whether the visual, topographic, and endothelial cell count result s observed 1 year after deep lamellar endothelial keratoplasty (DLEK) surgery re main stable up to 2 years after surgery. Prospective, noncomparative, interventi onal case series. Twenty eyes of 20 patients with corneal edema from Fuchs’endo thelial dystrophy. Deep lamellar endothelial keratoplasty endothelial replacemen t surgery, with a 9.0-mm or 9.5-mm scleral access incision and a specialized i ntrastromal trephine, was performed. Snellen visual acuities, corneal topography , and endothelial cell counts were prospectively measured preoperatively and 1 y ear and 2 years after DLEK. Uncorrected and best spectacle-corrected visual acu ity (BSCVA), refractive and topographic astigmatism, mean corneal curvature, top ographic regularity and symmetry, and endothelial cell density. At 1 year postop eratively, BSCVA averaged 20/50 (range, 20/25-20/200), spherical equivalents (S E)averaged -0.194±1.521 diopters (D), manifest refraction (MR) astigmatism ave raged 2.04±1.05 D (range, 0.0-4.0 D), topographic astigmatism averaged 2.3±1. 1 D, mean corneal curvature was 43.2±1.8 D, the surface regularity index (SRI) averaged 1.16±0.41, and the surface asymmetry index (SAI) averaged 1.05±1.09. At 2 years postoperatively, BSCVA averaged 20/48 (range, 20/25-20/200), SEavera ged-0.369±1.267 D, MR astigmatism averaged 1.76±0.66 D (range, 0.75-3.0 D), topographic astigmatism averaged 2.4±1.1 D, mean corneal curvature was 43.6±1. 8 D, the SRI averaged 1.13±0.44, and the SAI averaged 0.76±0.59. There was no significant change in visual or topographic parameters between 1 year and 2 year s postoperatively (P > 0.05). Endothelial cell counts averaged 2 335±468 cells/ mm2 at 1 year and 2 151±457 cells/mm2 at 2 years postoperatively (P=0.041). Dee p lamellar endothelial keratoplasty provides stable refractions, corneal topogra phy, and endothelial cell densities as long as 2 years after surgery. The absenc e of corneal sutures in this technique seems to prevent the sutures in/sutures o ut changes in SE refractions and corneal topography sometimes seen after penetra ting keratoplasty (PK). Deep lamellar endothelial keratoplasty is, therefore, an excellent alternative to PK for patients with endothelial dystrophies.
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