Endothelial cell loss after pars plana vitrectomy in patients with previous endothelial keratoplasty

To describe the changes in endothelial cell density after pars plana vitrectomy (PPV) in patients with previous Descemet stripping with automated endothelial keratoplasty (DSAEK).

Pars plana vitrectomy was performed in 3 eyes after DSAEK (16, 14, and 7 months, respectively). Two patients had a retinal detachment and the third patient had an epiretinal membrane. The cell population density and corrected distance visual acuity (CDVA) were measured before and after PPV.

Two months after PPV, the average endothelial cell loss was 11.12% (range 10.3%-12.15%). One patient lost 2 lines of CDVA and the other 2 patients lost only half a line of Snellen CDVA.

Patients who have undergone DSAEK may experience accelerated endothelial cell loss after a subsequent PPV procedure but the extra cell loss should not pose a short-term risk to graft viability unless the endothelial cell density was already borderline.