Rationale for performing penetrating keratoplasty rather than DSAEK in patients with bullous keratopathy in Japan.

BACKGROUND AND OBJECTIVE To analyze the rationale for performing penetrating keratoplasty (PK) rather than Descemet's stripping automated endothelial keratoplasty (DSAEK) in patients with bullous keratopathy (BK) in Japan. PATIENTS AND METHODS A total of 136 eyes of 130 patients with consecutive BK were enrolled. Patients treated by DSAEK were categorized as the DSAEK group. The remaining patients were considered unsuitable for DSAEK due to the presence of risk factors, and were treated by PK (PK group). In both groups, the number of the patients and the causes of BK were analyzed. Also, specifically in the PK group, the reasons for not performing DSAEK were analyzed. RESULTS The causes of BK differed significantly between the two groups (P < .001). Risk factors considered unsuitable for DSAEK include significant stromal scarring, iris abnormalities, and lens abnormalities. CONCLUSION For successful DSAEK, risk factors and contraindications should be carefully evaluated before surgery.