Descemet stripping only procedure may repair corneal endothelium

2021-12-24 10:14:57 By : Mr. Karl Lee

Dhaliwal DK. Will cornea become obsolete? Presented at: Eyecelerator; Nov. 11, 2021; New Orleans. transplantation

Dhaliwal DK. Will cornea become obsolete? Presented at: Eyecelerator; Nov. 11, 2021; New Orleans. transplantation

NEW ORLEANS — With an international shortage of donor corneal tissue, a procedure that uses a patient’s own cells to repair the endothelium may be a viable alternative for transplantation, according to an expert here.

Deepinder K. Dhaliwal, MD, said at the Eyecelerator meeting that Fuchs’ endothelial corneal dystrophy, the most common kind of endothelial dysfunction, is typically treated with either descemetorhexis without endothelial keratoplasty or Descemet’s stripping automated endothelial keratoplasty.

“We strip away that endothelial diseased layer,” she said. “Then, we’re going to put a transplant in.

“Although we’ve had beautiful innovations in transplantation, it’s still surgery.”

She said that both of these procedures have steep learning curves and require long patient recovery times.

A newer option, Dhaliwal said, is Descemet stripping only, in which only the central portion of the endothelium is removed and no donor graft is placed.

“If you remove just that central diseased Descemet in the endothelium, it’s going to release contact inhibition, and then the healthy peripheral cells can migrate centrally,” she said.

Dhaliwal said the procedure has a 90% success rate in patients who are good candidates and high patient acceptance. In terms of safety, it has the benefit of no adverse events from steroids and does not have the rejection issues seen with transplantations.

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