ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1499422
Comparative study of effectiveness and safety between non-Descemet stripping endothelial keratoplasty and Descemet stripping endothelial keratoplasty for endothelial decompensation
Provisionally accepted
- Nanning Aier Eye Hospital, Nanning, Guangxi Zhuang Region, China
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Purpose: To compare the potential effectiveness and safety of non-Descemet stripping endothelial keratoplasty (nDSEK) and Descemet stripping endothelial keratoplasty (DSEK) in treating endothelial decompensation.A retrospective comparative analysis was conducted on patients with endothelial decompensation who underwent either nDSEK or DSEK procedures between August 2017 and January 2024. Participants were observed for a minimum duration of twelve months. The study documented key variables like best corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), and any issues that occurred during the follow-up period.Results: A total of 85 eyes from 85patients (nDSEK n=40 eyes, DSEK n=45 eyes) were ultimately included in the study for analysis based on the inclusion and exclusion criteria. The mean BCVA (logMAR) showed significant improvement from the preoperative measurement of 1.66±0.26 to 0.37±0.11 in nDSEK eyes and from the preoperative 1.68±0.24 to 0.36±0.10 in 2 DSEK eyes respectively at postoperative 12 months. However, there was no statistically significant difference in the improvement of BCVA between the nDSEK and DSEK eyes (P=0.605). The mean donor ECD decreased from the preoperative 2814±85 cells/mm 2 to 1195±216 cells/mm 2 (ECL 57.5%) in nDSEK eyes and from the preoperative 2889±125 cells/mm 2 to 1266±285 cells/mm 2 (ECL 56.2%) in DSEK eyes respectively at postoperative 12 months, with no significant difference between the nDSEK and DSEK eyes (P=0.192). The occurrence of various complications (e.g. graft dislocation, acute hypertension, primary graft failure, graft rejection) was comparable between nDSEK and DSEK eyes.Conclusions: nDSEK eliminated the descemetorhexis step but yielded a comparable clinical outcome in effectiveness and safety compared to DSEK for treating endothelial decompensation.
Keywords: Descemet Stripping Endothelial Keratoplasty, Non-Descemet stripping endothelial keratoplasty, Endothelial decompensation, Endothelial keratoplasty, Treatment
Received: 20 Sep 2024; Accepted: 02 May 2025.
Copyright: © 2025 Huang, Yin, Hoang, Wu, Teng, Liang, Zhang and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Minghai Huang, Nanning Aier Eye Hospital, Nanning, Guangxi Zhuang Region, China
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