A clinicopathologic series of primary graft failure after Descemet's stripping and automated endothelial keratoplasty.


Journal Article

PURPOSE: To characterize the clinical and histologic features of primary graft failure after Descemet's stripping and automated endothelial keratoplasty (DSAEK). DESIGN: Retrospective observational case series. PARTICIPANTS: Sixteen cases of DSAEK graft failure from 15 patients, all with detailed histologic examination of failed graft tissue. METHODS: Hematoxylin-eosin, periodic acid-Schiff staining, and light microscopy were used to examine the failed DSAEK graft tissue from all patients. MAIN OUTCOME MEASURES: Examination of specimens for corneal endothelial cell viability and host-donor interface characteristics. RESULTS: Clinical history revealed that 88% (14/16) of studied DSAEK grafts detached before failure, and pathologic examination found that 75% (12/16) of failed grafts had atrophic corneal endothelium. Examples of residual host Descemet's membrane in the graft site and improper donor trephination were also identified. CONCLUSIONS: Marked loss of the corneal endothelium is the prominent feature of primary DSAEK graft failure. Examples of surgical features, such as incomplete Descemet's stripping and residual full-thickness cornea with a DSAEK graft, are shown.

Full Text

Cited Authors

  • Oster, SF; Ebrahimi, KB; Eberhart, CG; Schein, OD; Stark, WJ; Jun, AS

Published Date

  • April 2009

Published In

Volume / Issue

  • 116 / 4

Start / End Page

  • 609 - 614

PubMed ID

  • 18962919

Pubmed Central ID

  • 18962919

Electronic International Standard Serial Number (EISSN)

  • 1549-4713

International Standard Serial Number (ISSN)

  • 0161-6420

Digital Object Identifier (DOI)

  • 10.1016/j.ophtha.2008.08.036


  • eng