Cuadrado, Alberto Villarrubia , Sanchez-Ventosa, Alvaro , Gonzalez-Cruces, Timoteo , Diaz-Mesa, Vanessa , Villalva-Gonzalez, Marta , Miranda, Elisa Palacin , Perez, Maria Dolores Lopez , Perez-Angulo, Javier Gersol , Diaz-Ramos, Jose Carlos , Cano-Ortiz, Antonio
No
Graefes Arch. Clin. Exp. Ophthalmol.
Article
Científica
05/05/2025
001481467400001
Background Descemet Stripping Only (DSO) is a minimally invasive procedure for Fuchs' Endothelial Corneal Dystrophy (FECD) that leverages peripheral endothelial regeneration without donor tissue. This study evaluates visual and anatomical outcomes of DSO and the role of guttae distribution in recovery. Methods A prospective study included 30 eyes of FECD patients undergoing DSO. Patients were classified by guttae distribution: type A (central) or type B (0 degrees-180 degrees meridian). Preoperative and postoperative outcomes, including corrected distance visual acuity (CDVA), central corneal thickness (CCT), and endothelial cell density (ECD), were assessed over 12 months. Results Of 26 patients completing follow-up, 42.31% achieved a CDVA >= 0.22 logMAR by week 4, and 84.62% by month 12. Type B patients recovered faster, reaching CDVA >= 0.10 logMAR in 56 days versus 112 days for type A. Mean CCT improved from 606.96 +/- 60.97 mu m to 550.40 +/- 29.67 mu m (p = 0.0001). Postoperative ECD averaged 1402.7 +/- 130.56 cells/mm(2). Corneal densitometry improved significantly but remained higher than controls. Conclusions DSO is an effective treatment for FECD with adequate peripheral endothelial reserve. Guttae distribution affects recovery speed, but final outcomes are similar. If no improvement occurs by the third month, a rescue DMEK is effective. Keratometry remains unchanged, epithelial thickness slightly increases, and corneal densitometry improves postoperatively.
Fuchs' endothelial corneal dystrophy; Descemet stripping only (DSO); Guttae distribution patterns; Endothelial cell density (ECD); Corneal clearance; Minimally invasive surgery