[Effect of temporary anchor sutures on Descemet stripping endothelial keratoplasty in aphakic eyes]

To investigate the feasibility, efficacy, and complications of the temporary anchor sutures for endothelial graft fixation in Descemet stripping endothelial keratoplasty (DSEK) in aphakic eyes.

Non-randomized retrospective case series. Twelve consecutive cases (12 eyes) with aphakic bullous keratopathy underwent DSEK using the temporary anchor sutures technique for fixation of donor button in Zhongshan Ophthalmic Center between April to December in 2007. All cases were resulted from lens extraction and best spectacle-corrected visual acuity (BSCVA) was inferior or equal to 0.04. Eight cases were with preoperative pain. Prospective data of BSCVA, corneal astigmatism, curvature and thickness were collected on all 12 eyes preoperatively and at 3, 6 and 12 months postoperatively. Average endothelial cell density (ECD) and endothelial cell loss (ECL) were recorded at 6 and 12 months postoperatively. The follow-up period was 12 to 20 months.

All cases were performed DSEK successfully using the temporary anchor sutures and the grafts were well-attached without dislocation. On postoperative day 1, papillary block glaucoma occurred in 2 eyes and mannitol 20% was administered intravenously. The intraocular pressure in the 2 eyes returned to normal due to the air bubble absorption on postoperative day 2. The endothelial grafts showed mild to moderate edema in all eyes and became clear in 8 to 15 days postoperatively. All the corneas were clear during follow-up. In 12 months postoperatively, BSCVA was 0.7 in 16.7% of eyes (n = 2), 0.5 in 25.0% of eyes (n = 3), 0.4 in 33.3% of eyes (n = 4), and 0.3 in 25.0% of eyes (n = 3); mean corneal astigmatism was (2.40 + or - 0.70) diopters, mean corneal curvature was (45.40 + or - 1.50) diopters, and mean corneal thickness was (591.5 + or - 20.4) microm. Mean endothelial cell density (ECD) was (2088 + or - 146) cells/mm(2) [(28.9 + or - 3.9)% endothelial cell loss] and (1857 + or - 101) cells/mm(2) [(36.7 + or - 3.1)% endothelial cell loss] in 6 and 12 months postoperatively, respectively.

The temporary anchor sutures technique was easy to perform and effectively prevented graft dislocation and detachment into the vitreous cavity.