[1-year results after posterior lamellar keratoplasty with manually dissected donor tissue]

Posterior lamellar keratoplasty (PLK) is a reasonable alternative to penetrating keratoplasty (PK) for pathological changes of the corneal endothelium. The lamellar preparation of the donor tissue can be done in an automated fashion with a microkeratome, Descemet Stripping Automated Keratoplasty (DSAEK) or manually, Descemet Stripping Endothelial Keratoplasty (DSEK). Here, we describe our clinical results with one year follow-up using manually dissected donor lamellae for PLK.

For 28 eyes (28 patients) best-corrected visual acuity, corneal topography, esthesiometry, pachymetry, as well as endothelial cell count were measured before, 1 day, 1 and 6 weeks, as well as 3, 6 and 12 months after surgery.

3 of 28 grafts showed primary graft failure. For 19 eyes (no other vision-limiting diseases), the best-corrected visual acuity rose on average from 1.0 +/- 0.53 to 0.4 +/- 0.20 (logMAR) 1 year after surgery. The surgically induced astigmatism changed from 3.8 +/- 2.8 dpt preoperatively to 1.4 +/- 1.0 dpt 12 months after DSEK. The pachymetry measured by slit lamp showed an averaged thickness of 649 +/- 54 mm pre- and 776 +/- 75 mm one week and 636 +/- 79 mm 1 year after surgery was performed. The endothelial cell count of the grafts was 2615 +/- 156 cells/mm (2), after one year postoperatively the mean endothelial cell count was 2084 +/- 536 cells/mm (2). The esthesiometry showed a slight rise from 0.96 +/- 0.34 g/mm (2) pre- to 0.96 +/- 0.03 g/mm (2) one year post-surgery.

The postoperative course of our patients shows that improvement of visual acuity by PLK with manually dissected donor tissue is possible.