June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) vs Ultra-Thin DSAEK (UT-DSAEK) vs Descemet’s Membrane Endothelial Keratoplasty (DMEK)
Author Affiliations & Notes
  • Peng Yan
    Ophthalmology, University of Ottawa - Eye Institute, Ottawa, ON, Canada
  • Salina Teja
    Ophthalmology, University of Ottawa - Eye Institute, Ottawa, ON, Canada
  • Kashif Baig
    Ophthalmology, University of Ottawa - Eye Institute, Ottawa, ON, Canada
  • Footnotes
    Commercial Relationships Peng Yan, None; Salina Teja, None; Kashif Baig, Bausch and Lomb (F), Allergan (C), Alcon (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1749. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Peng Yan, Salina Teja, Kashif Baig; Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) vs Ultra-Thin DSAEK (UT-DSAEK) vs Descemet’s Membrane Endothelial Keratoplasty (DMEK). Invest. Ophthalmol. Vis. Sci. 2013;54(15):1749.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: To compare the surgical and visual outcomes between DSAEK, UT-DSAEK and DMEK as treatments for Fuch’s Endothelial Dystrophy (FED) and Pseudophakic Bullous Keratopathy (PBK).

Methods: The first ten consecutive DSAEK, UT-DSAEK, and DMEK patients with either FED or PBK were reviewed retrospectively. In DSAEK, a 350um head was used for all single-pass dissections. In UT-DSAEK, donor corneas were prepared by a two-pass microkeratome dissection. In DMEK, a trephine-peel technique was used to prepare the graft. Data was collected from baseline up to 6-months follow-up, and outcomes including intraoperative and postoperative complications, visual rehabilitation, endothelial cell density and follow-up graft thickness were compared.

Results: The average age was 76, 69, and 67.5 years for DSAEK, UT-DSAEK, and DMEK respectively. All patients had previous cataract extraction and intraocular lens placement, with an equal number of FED and PBK presentations. Mean donor endothelial cell count was 2597 for DSAEK, 2590 for UT-DSAEK group and 2709 for DMEK. No donor tissues were lost during tissue preparation. The DSAEK group had a mean preoperative best-corrected visual acuity (BCVA) of 20/200 with mean intraocular pressure (IOP) of 17mmHg. The UT-DSAEK group had a mean preoperative BCVA of 20/80 with mean IOP of 13mmHg. The DMEK group had a mean pre-operative BCVA of 20/120 with mean preoperative IOP of 14mmHg. One patient in the DMEK group had a large persistent peripheral graft detachment despite 3 re-bubbling attempts and required a second DMEK procedure. Six-month outcomes of visual rehabilitation, endothelial cell loss, graft thickness and graft rejection for all patients will be available by March 2013.

Conclusions: Endothelial Keratoplasty is constantly evolving, with DSAEK currently being the standard of care. Available literature has shown the benefits of UT-DSAEK and DMEK, including lower rates of graft rejection, faster and greater visual recovery and comparable endothelial cell loss. The difficulties with tissue preparation however, have resulted in a slower transition to these two procedures. This comparison of outcomes between our first 10 consecutive patients having each procedure will shed light on the relative learning curve and encourage corneal surgeons to consider the benefits of providing these advanced treatments to their patients.

Keywords: 741 transplantation • 481 cornea: endothelium • 479 cornea: clinical science  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×