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Sara Akbari, Shahzad Mian, David Musch, Leslie Niziol; Comparison Of Insertion Technique Outcomes In Descemet’s Stripping Automated Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2011;52(14):744.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the outcomes of three surgical techniques for insertion of donor disc in patients undergoing Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK).
Retrospective review of DSAEK cases performed by 4 surgeons between February 2007 and March 2009. Surgical techniques reviewed included forcep assisted pulling and needle assisted pushing of the donor lenticule, and forcep assisted insertion of a 60-40 folded donor lenticule (taco). Preoperative clinical characteristics, surgical technique, postoperative complications, visual acuity, manifest spherical equivalent, and cylindrical correction were recorded. Statistical comparisons were made using t-tests, Chi-square, and ANOVA tests.
100 eyes of 100 patients underwent DSAEK with 51,19, and 30 eyes receiving the taco, push, and pull insertion techniques, respectively. There were no differences in best corrected visual acuity (BCVA) at 6 months and 1 year post-operatively (one way ANOVA, all p > .25) when comparing all three technqiues. The BCVA improved significantly in the first 6 months postoperatively in all 3 groups with no significant change from 6 month to 1 year postoperatively. A statistically significant hyperopic shift of 0.86 diopters was observed, with no difference in the shift across the three groups (p>0.5). There was no significant astigmatic change at any time point (p>0.3). A comparison of post-operative complication rates revealed similar donor dislocation rate of 19% amongst all three techniques (p=0.61)
All three techniques for donor disc insertion in DSAEK are equally effective at all post-operative time points with similar visual acuity outcomes. The techniques result in a similar hyperopic shift and are astigmatically neutral. Additionally, dislocation rates are similar amongst the three techniques.
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