Descemet-stripping endothelial keratoplasty: improvement in vision following replacement of a healthy endothelial graft

J Cataract Refract Surg. 2008 Jun;34(6):1044-6. doi: 10.1016/j.jcrs.2008.01.030.


We describe a case of endothelial graft exchange in a patient who had inadequate vision without a clinically identifiable cause following Descemet-stripping endothelial keratoplasty (DSEK). The initial DSEK was performed with a hand-dissected donor, and the replacement graft was prepared with an automated microkeratome. The best spectacle-corrected visual acuity (BSCVA) improved from 20/50 before replacement to 20/25 after replacement. Although DSEK provides rapid recovery of excellent vision, few patients achieve a BSCVA of 20/20. Some have substandard vision with no clinically identifiable cause. This case demonstrates that replacing a hand-prepared graft with an automated microkeratome-prepared graft may improve vision in patients with no identifiable cause for visual loss.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Corneal Transplantation / methods*
  • Descemet Membrane / surgery*
  • Endothelium, Corneal / transplantation*
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Male
  • Middle Aged
  • Reoperation
  • Vision Disorders / rehabilitation*
  • Visual Acuity