AIM: To evaluate the clinical effects and safety of surgical techniques in Descemet stripping automatic endothelial keratoplasty(DSAEK)in bullous keratopathy.

METHODS: A retrospective analysis of 10 patients with bullous keratopathy treated in our hospital from December 2018 to December 2019 in our hospital, including 4 males(4 eyes), 6 females(6 eyes). Descemet stripping automatic endothelial keratoplasty(DSAEK)was performed with every patient. In addition to the conventional surgical procedures, the surgical technique such as the setting of the anterior chamber perfusion tube, the design of the incision, and the peripheral corneal puncture during the operation were performed. Follow-up for 6mo, the recovery of corneal grafts and postoperative dislocations, double anterior chambers, and other complications were observed, including best corrected visual acuity(BCVA), anterior segment optical coherence tomography, corneal endothelial cell count and incidence of postoperative complications.

RESULTS: All patients had smooth surgery, no intraoperative complications occurred, and no postoperative dislocations or interlaminar effusions occurred; postoperative intraocular pressure was normal, and the BCVA was improved to different degrees than before surgery. The symptoms such as tearing and photophobia gradually reduced from 1d after surgery, and completely relieved after 2wk. Corneal stroma edema decreased within 1mo after operation, and the central corneal thickness(596.8±19.11μm)was significantly thinner than that before operation(874.0±58.64μm). During the follow-up period, all patients were stable and the corneal grafts remained transparent, but the corneal endothelial counts were reduced to varying degrees.

CONCLUSION: The application of surgical techniques in DSAEK can significantly reduce intraoperative and postoperative complications, improve the safety of surgery, and has clinical value in bullous keratopathy.