[Preliminary clinical study of non-Descemet stripping endothelial keratoplasty for bullous keratopathy]

To investigate the feasibility and clinical effect of non-Descemet stripping endothelial keratoplasty for bullous keratopathy.

In the prospective consecutive case series, 6 patients (6 eyes) with bullous keratopathy at Affiliated Xiamen Eye Center of Xiamen University from September 2007 to January 2009 underwent non-Descemet stripping endothelial keratoplasty. During the surgical procedures, the recipient's Descemet membrane and endothelial layer were left untreated. The donor tissue disc consisting of posterior stroma and healthy endothelium from a donor cornea was implanted into the anterior chamber from a limbal tunnel incision, then unfolded and pressed against the recipient cornea with sterile air filled in anterior chamber. All patients were followed up for 6 - 20 months, pre- and postoperative best corrected visual acuity (BCVA) were compared, the adherence of the donor disc to the recipient endothelium and postoperative donor disc dislocation were monitored during the follow-up period. Graft clearance and endothelial cell density (ECD) were observed, too.

Five donor disc were well adhered to the recipient endothelium and no graft dislocation occurred during the follow-up period. One case showed a narrow gap between the host endothelium and donor disc 1 day postoperatively. This patient was told to stay in prone position and the donor disc readhered well. All the grafts remained transparent until the latest follow-up. Five patients had improved BCVA while 1 patient had the same BCVA. The reason for poor VA was optic atrophy due to trauma. Postoperative mean EDC was (1648 + or - 384) cells/mm(2).

Non-Descemet stripping endothelial keratoplasty for bullous keratopathy is feasible, technically easy, safe and effective. It can be one of the surgical treatment option for bullous keratopathy.