[Functional results after endothelial queratoplasty: three years of experience]

To study the refractive and visual results after Descemet's stripping automated endothelial queratoplasty (DSAEK).

Retrospective study of 75 eyes in 67 patients with Fuchs' endothelial dystrophy or bullous queratopathy operated on in the Instituto de Oftalmología La Arruzafa from March, 2007 until March, 2010. Phacoemulsification and IOL implantation was involved in 30 cases. We divided all cases into three groups, depending on the potential visual acuity: A (≤ 0.1), B (0.1-0.5) and C (≥ 0.5). Uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA) and refraction were measured.

Mean CDVA improved 3 lines compared to preoperative values (P<.01). Astigmatism increased by 0.5 dioptres (P=.21). A slight myopic change was found in cases where the donor disc was≥8.5mm, as well as in the cases in which phacoemulsification was associated. No correlation between CDVA and donor disc thickness was found. In the group of patients who only had corneal oedema, the mean CDVA was 0.8. No patients ended with less than 0.6 of CDVA and the mean UCVA was 0.5.

After DSAEK, CDVA improved with a slight hyperopic change, without significant changes in astigmatism. Donor disc thickness does not influence the CDVA. DSAEK is an effective surgical technique to restore a good visual acuity in cases with corneal oedema due to endothelial failure.