OUTCOMES OF DESCEMET STRIPPING ENDOTHELIAL KERATOPLASTY (DSEK) AND DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY (DMEK) FOR HERPETIC ENDOTHELIAL DECOMPENSATION

To evaluate the efficacy and safety of DSEK and DMEK in managing endothelial decompensation secondary to herpetic keratitis and to compare the postoperative visual acuity and complication rates between the two techniques.

Tertiary referral ophthalmic center Corneal Department

A retrospective analysis was conducted on 20 eyes with herpetic endothelial decompensation, of which 12 underwent DSEK and 8 underwent DMEK. All surgeries were performed by the same surgeon. Primary outcomes included graft survival and best-corrected visual acuity (BCVA) at 6 months postoperatively. Secondary outcomes included the rate of complications, such as graft failure, recurrence of epithelial keratitis, and endothelialitis. Statistical analysis was used to evaluate differences in visual acuity and complication rates between the groups.

At 6 months, BCVA was comparable between the DSEK and DMEK groups (p > 0.05). Graft survival was observed in 19 out of 20 cases; one DMEK graft failed after 6 months. Complications included one case of epithelial Herpetic keratitis in the DSEK group and one case of recurrent endothelilitis in the DMEK group. Both groups showed satisfactory clinical outcomes with a low rate of serious complications, and no significant difference in visual acuity recovery at 6 months.

DSEK and DMEK are both viable options for herpetic endothelial decompensation, demonstrating comparable visual recovery and complication rates. The choice of procedure can be tailored based on patient and surgeon preference, given the similar efficacy and safety profiles observed in this cohort.