AIIMS November 2011 – MCQ 43

What percentage of endothelial cells are lost in Descemet’s stripping automated endothelial keratoplasty ?
A. 5%
B. 10-20%
C. 30-40%
D. 50-60%

Correct answer : C. 30-40%

Cell loss with the usual DSEK technique was found to be 34% at 6 months and 38% at 12 months. Cell loss in modified DSEK (using underfold technique) was found to be 26% at 6 months and 27% at 12 months.

References:

Ophthalmology. 2008 May;115(5):857-65. Epub 2007 Sep 14.
Endothelial cell loss after descemet stripping with endothelial keratoplasty influencing factors and 2-year trend.
Price MO, Price FW Jr.

“Mean endothelial cell density was 2000+/-550 cells/mm(2) 6 months after Descemet stripping with endothelial keratoplasty (DSEK), representing cell loss of 34+/-18%.”

Ophthalmology. 2010 Mar;117(3):438-44. Epub 2010 Jan 19.
Descemet’s stripping automated endothelial keratoplasty outcomes compared with penetrating keratoplasty from the Cornea Donor Study.
Price MO, Gorovoy M, Benetz BA, Price FW Jr, Menegay HJ, Debanne SM, Lass JH.

“Percent endothelial cell loss was 34+/-22% versus 11+/-20% (6 months) and 38+/-22% versus 20+/-23% (12 months) in the Descemet stripping with endothelial keratoplasty (DSAEK) and Penetrating keratoplasty (PKP) groups, respectively ”

Cornea. 2010 Sep;29(9):1022-4.
Endothelial cell damage in descemet stripping automated endothelial keratoplasty with the underfold technique: 6- and 12-month results.
Chen ES, Phillips PM, Terry MA, Shamie N, Friend DJ.

“In this study, 305 eyes undergoing DSAEK were evaluated. Average endothelial cell loss was 26% at 6 months and 27% at 12 months, all statistically significant reductions from preoperative values (P < 0.01). “