Postoperative Outcomes Of Descemet Stripping Only (Dso) For Fuchs Endothelial Corneal Dystrophy.

In this single-centre study, we aim to present postoperative outcomes of Descemet stripping only procedure in patients with Fuchs endothelial corneal dystrophy (FECD) in the last 5 years.

Eye Hospital University Medical Centre Ljubljana

A retrospective cohort of 36 eyes of 31 patients with decreased best corrected visual acuity (BCVA) and central corneal oedema due to FECD was analysed, from January 2019 to December 2024. Pre- and postoperative examination included BCVA, specular biomicroscopy for central endothelial cell count (cECC), and corneal pachymetry for central corneal thickness (CCT). The patients underwent DSO surgery in one or both eyes. All patients completed at least 12 months of postoperative follow-up [12-58 months, average 31.8 months].

Endothelial repopulation of central stroma was observed in 26 of 36 eyes(72% of cases). On average, measurable values of cECC were established in 7,5 months[1-50 mo]. The average initial postprocedural cECC value was 573 cells/mm²[354 - 2197]. Improvement in corneal clarity was achieved with an average CCT decrease of 44μm, and VA improved with average BCVA increase 0,28 [0,4-1,0](Snellen)([0,1-0,9] preop. to [0,4-1,0] postop.). In the early postoperative period 2 eyes developed CMO, resolving after topical therapy. In 10 eyes failing to achieve endothelial repopulation, 5 were lost to follow-up and 4 underwent subsequent DMEK, 1 eye with persistent endothelial decompensation required further topical intervention with rho kinase inhibitors.

DSO is proving to be a promising management approach in treatment of corneal endothelial diseases, including FECD. This minimally invasive procedure omits dependence on donor tissue availability and eliminates graft-related complications. Duration of postsurgical therapy is brief and does not require long term use of topical corticosteroids, attributing to glaucoma. Thus, DSO may prove to be a comparable or even preferable surgical intervention to standard corneal keratoplasty techniques.