Study finds, Long-term Outcomes of Descemet Stripping Endoth
A Study was conducted to describe 10-year outcomes for graft and endothelial cell survival after Descemet stripping endothelial keratoplasty (DSEK), including risk factors for graft failure.

356 consecutive DSEK grafts performed by 10 surgeons using a standardized protocol were analyzed. Primary outcomes were cumulative graft survival and percentage endothelial cell loss (ECL) from 6 months to 10 years; secondary outcomes included risk factors for graft failure, postoperative complications, visual outcomes, and central corneal thickness.

--Indications include Fuchs’ endothelial dystrophy (n=209), bullous keratopathy (n=88), and previous graft failure (n=39).

--104 eyes (29%) had preoperative glaucoma. Cumulative graft survival of all eyes at 1, 3, 5, and 10 years were 97%, 90%, 85%, and 79%. 10-year graft survival for Fuchs’ endothelial dystrophy was 92%.

--Percentage ECL of all grafts were 46.6 ± 17.3 at year 1, 54.9 ± 18.7 at year 3, 59.6 ± 17.4 at year 5, and 73.1 ± 9.7 at year 10.

--Cox regression identified preoperative glaucoma, including previous glaucoma surgery, and regrafts as significant risk factors for graft failure.

Conclusively, the DSEK survival rate for all eyes, including complex grafts, was 79 percent after ten years, whereas the ECL survival rate was 73 percent. The 10-year graft survival rate for FED was 92 percent. Despite a low endothelial cell count of 692 cells/mm2 over 10 years, graft survival was high with adequate vision. DSEK remains a feasible therapy option, particularly in eyes with comorbidities.