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Purpose: To compare the results of treatment of 2 groups of patients with the Central Form of Fuchs Endothelial Corneal Dystrophy, treated by Central Descemetorhexis (DSO or DWEK).

Methods: Retrospective analysis of 2 groups of patients. Both groups were similar in age, sex, and severity of Dystrophy: Confluent guttae at central 4.0 – 5.5 mm, peripheral Endothelial Cells Count 1,200 – 2,200, with 45% – 65% of Hexagonal Cells. In both groups, DSO was a part of the Triple Procedure: Phaco + IOL implantation + DSO. First group: 12 eyes of 12 patients. The Descemetorhexis was performed using the standard method, starting with the formation of a Descemet membrane tear using a Reverse Sinski Hook. The second group: 8 eyes of 8 patients. The Descemetorhexis was formed by the “atraumatic” method. The Descemetorhexis was initiated at the Descemet membrane incision using the sharp side-port blade. The original instrument with the mushroom-shaped working head was used to atraumatically separate the Descemet membrane from the corneal stroma and to perform the Descemetorhexis. Standard postoperative treatment, including topical antibiotics, anti-inflammatories, hyperosmotic, and artificial tears, for both groups. Topical Rho Kinase (ROCK) Inhibitors were not certified in Ukraine and were not used. Follow up from 6 months to 3 years.

Results: Restoration of a continuous endothelial cells layer (Re-Endothelization) with the normalization of stromal thickness, restoration of transparency, and the possibility of Central endothelial cells count (≤ 600+ Cells): 10 (out of 12) eyes from Group 1 Re-Endothelized. Mean time: 6.2 +/- 3.3 weeks. 2 eyes did not, and DMEK/DSAEK procedures were performed 6+ months after DSO. All 8 eyes in Group 2 were successfully Re-Endothelialized. Mean time: 4.3 +/- 3.8 weeks.

Discussion: It is well known that an irregular stromal surface slows, or in extreme cases, prevents the migration of endothelial cells (Re-Endothelisation). Tearing the Descemet membrane by Reverse Sinski Hook inevitably traumatizes the inner surface of the corneal stroma. Thus, performing the DSO by using a standard method may slow the migration of Endothelial cells.

Conclusions: In these 2 small groups of patients, performing an “atraumatic” DSO approach with the Descemet membrane incision as a starting point and using the original instrument with the mushroom-shaped working head seems beneficial for faster rehabilitation (Re-Endothelization).