To evaluate the long-term results of Descemet's stripping automated endothelial keratoplasty in Korea (DSAEK).

Seven patients with bullous keratopathy who underwent DSAEK and who were followed-up for more than 18 months were reviewed retrospectively. Best corrected visual acuity, refraction, corneal thickness, and endothelial cell count were examined before and after surgery.

The mean follow-up period was 19.9 ± 2.9 months (18 to 24 months), and the mean age was 61.42 ± 10.13 years (46 to 76 years). Six patients (85.7%) showed successful results after surgery. Best corrected visual acuity (logMAR) was significantly improved from 1.62 (median) to 1.15 (median) ( p = 0.027) at one month after surgery and was maintained until the final follow-up period. There were no statistical differences in spherical ametropia or astigmatism before or 18 months after the operation. Graft failure was observed in one case, in which penetrating keratoplasty was performed 12 months after DSAEK.

Long term results of DSAEK showed fast visual recovery, low ametropia and astigmatism. DSAEK may be a good option for the surgical management of corneal endothelial disease.