Descemet's Stripping Without Endothelial Keratoplasty

Daniel Garcerant; Nino Hirnschall; Nicholas Toalster; Meidong Zhu; Li Wen; Gregory Moloney

Disclosures

Curr Opin Ophthalmol. 2019;30(4):275-285. 

In This Article

Patient Factors

Both our series and that of Davies et al.[45] attempted analysis to determine what predictive factors might exist for corneal clearance. Both groups in small to medium cohorts were unable to identify clinical or demographic factors of significance. Davies et al.[45] noted that in patients undergoing fellow eye treatment, clearance time was strikingly similar, suggesting a role for patient factors which thus far remain unclear. A clear link in our center between trinucleotide repeat load and time to clearance has not been established albeit in a small sample size (unpublished data) It is worth noting that in an in-vitro analysis of endothelial cell migration by Soh et al.[48] identified younger patient age and the presence of an intact Descemet's membrane as factors capable of promoting cell locomotion. Okumura et al.[49] also found improved endothelial cell migration after removal of the central endothelium if Descemet's membrane was preserved rather than stripped. This would suggest that a roughened stromal surface, or bare stromal surface is a retardant of endothelial cell migration, and again emphasizes the effect of surgical factors on the success of this procedure.

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