Authors' objectives: To assess the efficacy/effectiveness, safety and cost of the DSAEK technique per se or in comparison with PK, in patients with corneal endothelial failure.

Authors' recommendations: In Fuchs' dystrophy and bullous keratopathy, data on the effectiveness of DSAEK indicate post-intervention improvement in uncorrected and best-corrected visual acuity in relation to baseline values registered prior to the procedure. According to the studies located, post-DSAEK outcomes for BCVA and degree of astigmatism are similar to or even better than those achieved with PK. The most important post-DSAEK complications are linked to the viability of the graft, with the most frequent of these being dislocation-detachment and, to a lesser extent, endothelial rejection. In PK, rejection is the most frequent complication. In DSAEK, the learning curve is a key factor and is directly linked to the success of the graft transplantation. The long-term graft survival rate is similar with both techniques. Economic evaluation data show that as compared to PK, DSAEK is a cost-effective technique. The studies that assess DSAEK are case series, for the most part retrospective. The methodological quality of such studies tends to be low and limited, and so when it comes to recommending or discouraging the adoption of this technique, their results should be approached with caution.

Project Status: Completed

Year Published: 2013

URL for published report: http://www.sergas.es/Docs/Avalia-t/avalia-t201209Queratoplastia.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)

Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;

Contact Name: avalia-t@sergas.es

Contact Email: avalia-t@sergas.es

Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)