Abstract

SA.05.08

Histologic analysis of descemet membranes following descemet-stripping in posterior lamellar keratoplasty (DSAEK)

Heindl L. M., Rummelt C., Kruse F. E., Cursiefen C.
Department of Ophthalmology and University Eye Hospital, University Erlangen-Nürnberg, Erlangen

Objective: Posterior lamellar keratoplasty is a new procedure for the treatment of corneal endothelial diseases. The purpose of this study was to investigate how precise descemet-stripping works in posterior lamellar keratoplasty (DSAEK).
Methods: Histologic analysis of 10 descemet membranes following DSAEK. Descemet membranes were routinely stained with HE and PAS, examined for presence, localization and thickness of residual stroma, and the results were correlated with the underlying disease.
Results: Adherent rests of corneal stroma were present in only 1 of 10 descemet membranes. In this case, focal stromal adherences were located peripherally with a thickness of 7 µm as well as centrally with a thickness of 10 µm (underlying disease: PEX-keratopathy). In the 9 other descemet membranes without adherent stroma Fuchs’ dystrophy was diagnosed clinically and histopathologically. The thickness of descemet membranes averaged 9.3±0.9 µm in peripheral localization and 7.4±0.7 µm in central localization.
Conclusions: Descemet-stripping in DSAEK achieves complete and specific removal of descemet’s membrane in 90% of patients without adherent stroma.

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