Manual DSEK in patients with Pseudophakic Bullous Keratopathy: Viable option in resource limited settings

Abstract

Evaluation of success rate of manual DSEK in terms of central corneal thickness and BSCVA in patients of PBK. : Prospective, non-comparative, interventional study of 18 patients of PBK, who underwent manual DSEK between June 2021 to May 2022 with minimum six months to maximum 15 months post-operative follow up. DSEK lenticule was prepared by manual dissection. Push in technique with 26 G needle was used for graft insertion. Preoperative and post-operative CCT and BSCVA were measured and compared. : Preoperative central pachymetry in patients (n=18) was (832±162) μm which significantly reduced in the post operative period. The mean thickness of lenticule on day 1 post op was 203±93.5μm which became 156±76 μm (p =.0436) at 6 months and remained almost same till last follow up. Pre operative BSCVA ranged from HM to 2/60 in these 18 patients which was improved in 16/18 eyes post DSEK. Eighty eight percent (15/17) patients had regained BSCVA of 6/60 to 6/12. In early post operative period, complications noted were, partial detachment of lenticule and pupillary block glaucoma which were managed accordingly.: Manual DSEK is feasible, low-cost widely accessible alternative to DSAEK/DMEK for patients of PBK with good visual outcome in resource limited settings.: Manual DSEK has short learning curve and it’s training should be imparted to corneal surgeons for better outcome in PBK and other causes of endothelial decompensation.