To report a case of deep lamellar endothelial keratoplasty (DLEK) technique applied to a patient with Fuchs' dystrophy. The surgical procedure was performed on the right eye for a case of Fuchs' dystrophy with endothelial failure. Through a 9 mm self-sealing scleral tunnel incision, a stromal pocket was dissected at 0.35 mm depth. A 8.5 mm lamellar donor disc with 0.150 mm thickness, containing posterior stroma, Descemet's membrane and endothelium, was transplanted without corneal suture. Best spectacle-corrected visual acuity, biomicroscopy, topography, ultrasound pachymetry and endothelial cell density were evaluated. Before surgery, the patient presented best spectacle-corrected visual acuity of 20/100 (+4.00 -3.25 x 60º), astigmatism of 6.60 D (37.5 a 12º x 44.1 a 102º), ultrasound pachy-metry of 0.625 mm and endothelial cell density of 720 cel/mm². Three months after surgery, best spectacle-corrected visual acuity was 20/30 (-1.25 -0.50 x 45º), astigmatism was 1.00 D (37.2 a 75º x 38.2 a 165º); ultrasound pachymetry showed 0.503 mm and endothelial cell density showed 2447 cel/mm². Complications: intraoperative iris cut, disc edge dislocation, wrinkled disc and interface nebula. The preliminary results suggested that deep lamellar endothelial keratoplasty is an alternative to surgical treatment of Fuchs' dystrophy with endothelial failure. A greater number of cases and longer follow-up are necessary to better understand this keratoplasty technique and its outcome.
Corneal transplantation; Fuchs' endothelial dystrophy; Case report; Adult; Female
