Descemet Stripping Only (Dso) - Postoperative Outcomes In A Tertiary Eye Hospital
Published 2025 - 43rd Congress of the ESCRS
Reference: PO537 | Type: Free paper | DOI: 10.82333/92t0-0p96
Authors: Alfonso Arias-Puente* 1 , Jose L Rincon 2 , Lucia Infestas 3 , David P Piñero 2
1Ophthalmology,Rey Juan Carlos University,Madrid,Spain;Ophthalmology,Vithas Madrid University Hospital,Madrid,Spain, 2Ophthalmology,Vithas Medimar University Hospital,Alicante,Spain, 3Ophthalmology,Vithas Madrid University Hospital,Madrid,Spain
Purpose
To present results of Descemet Striping Only (DSO) in Eyes with Fuchs’ Endothelial Corneal Dystrophy (FECD) Operated at the Eye Clinic in Ljubljana Between 2019 and 2024
Setting
University Eye Hospital Ljubljana Slovenija
Methods
A retrospective analysis of documentation from 36 eyes of 31 patients who underwent DSO in one or both eyes. We analyzed central endothelial cell count (cECC), pachymetry (CCT), and best-corrected visual acuity (BCVA) before and after surgery. Patients were divided into two groups based on the method and extent of descemetorrhexis: one group where the diameter was adjusted to the area of guttata (Group 1, 13 eyes) and another group with a centrally round descemetorrhexis of 4-5 mm (Group 2, 23 eyes).
Patients were followed for 12 to 58 months, with an average follow-up period of 31.8 months.
Results
In Group 1, cECC was measurable in 12 out of 13 eyes (92%), while in Group 2, it was measurable in 14 out of 23 eyes (60%).
The average time to ECD establishment was 9.9 (±13.4) months in Group 1 and 5.9 (±5.0) months in Group 2.
Group 1: ECD values ranged from 554 to 1534 cells/mm², average 978.3 cells/mm² (±344.4).Group 2: ECD values ranged from 354 to 2332 cells/mm², average 1144.3 cells/mm² (±637.0).
The average best-corrected visual acuity (BCVA) in Group 1 was 0.62 before and 0.86 after surgery, with an average improvement of 0.24 (±0.18).
In Group 2, BCVA was 0.38 before and 0.62 after surgery, with an average improvement of 0.31 (±0.29).
Reduction in corneal edema was observed in 10 eyes (77%) in Group 1 and 18 eyes (78%) in Group 2.
Conclusions
Our retrospective study compared two methods of treating FECD with Descemetorrhexis (DSO). The method in which we removed or attempted to remove the visibly altered Descemet’s membrane regardless of the removed membrane size showed better best-corrected visual acuity and a higher percentage of eyes where endothelial cell count could be measured via specular microscopy. However, it resulted in lower endothelial cell density, likely due to the larger area that needed coverage by endothelial cells in Group 1, and a smaller reduction in pachymetry, possibly because the preoperative pachymetry was lower.