Corneal endothelial transplantation: results of a clinical series using deep lamellar endothelial keratoplasty (DLEK).

摘要

PURPOSE: We present the results of our clinical series replacing posterior stroma and endothelium only by deep lamellar endothelial keratoplasty (DLEK) in patients with corneal endothelial diseases. METHODS: Through a 9.0-mm superior scleral incision, a deep stromal pocket was created across the cornea. A 7.5-mm posterior lamellar disc of recipient tissue was excised and replaced by same-size donor posterior disc without suture fixation. Three cases were followed for 12 months after DLEK. Best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and corneal thickness were examined. RESULTS: At 12 months after surgery, all transplants were clear and in position. In the 3 cases, BSCVA at 12 months was 20/200 (hand motion before operation), 20/50 (6/200 before operation), and 20/60 (20/250 before operation), respectively. In one patient, postoperative endothelial cell density was 533 cells/mm(2) with a very thin donor disc. In the other two patients, postoperative endothelial cell density was >2000 cells/mm(2). Corneal thickness (+/-SD) averaged 0.51 +/- 0.06 mm. CONCLUSIONS: DLEK in the setting of corneal endothelial diseases is an effective surgical procedure without corneal surface incisions and sutures.