Official ESCRS | European Society of Cataract & Refractive Surgeons


A comparison of DSAEK and DMEK in the treatment of failed penetrating keratoplasty

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Session Details

Session Title: Cornea Surgical: Keratoplasties

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 17:06

Venue: Free Paper Forum: Podium 1

First Author: : A.Einan-Lifshitz ISRAEL

Co Author(s): :    Z. Mednick   A. Belkin   N. Sorkin   C. Chan   D. Rootman                 

Abstract Details


To compare the outcomes of Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) to Descemet Membrane Endothelial Keratoplasty (DMEK) for the treatment of failed penetrating keratoplasty (PKP).


Toronto Western Hospital, Toronto, Canada


Retrospective chart review of patients with failed PKP that underwent DMEK or DSAEK. The median follow-up time for both groups was 28 months (range 6-116 months). Data collection included demographic characteristics, number of previous corneal transplants, prior glaucoma surgeries, best corrected visual acuity (BCVA), endothelial cell density, graft detachment and rebubble rate, rejection episodes and graft failure.


28 eyes in the DMEK group and 24 in the DSAEK group were included in the analysis. 43% of the DMEK group and 50% of the DSAEK group had to be re-grafted due to failure (p=0.80). The most common reason for failure was persistent graft detachment (58%) in the DMEK group and secondary failure (58%) in the DSAEK group. Six eyes (21%) in the DMEK group and 7 eyes (29%) in the DSAEK group developed graft rejection (p=0.39). The BCVA 6 months after surgery was better in the DMEK group compared to the DSAEK group (p=0.051)


Both DSAEK and DMEK have a role in treating PKP failure. Primary failure due to persistent graft detachment was significantly higher in the DMEK group, though the overall failure rate in the medium-term became similar.

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