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A. D. Munro, S. Stinnett, T. Kim; Pre-Operative Donor Cornea Graft Thickness and Visual Acuity Outcomes in DSEK. Invest. Ophthalmol. Vis. Sci. 2010;51(13):773.
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To assess a relationship between pre-operative donor cornea graft thickness and visual acuity outcomes six months following Descemet Stripping Endothelial Keratoplasty (DSEK).
Retrospective review of patients (n=209) who underwent DSEK and were assessed six months post-operatively at Duke Eye Center. Best-spectacle corrected visual acuity (BSCVA) was obtained pre-operatively and six months post-operatively, and was subsequently converted into LogMAR visual acuity for analysis. Pre-operative donor cornea graft thickness was measured via pachymetry during graft preparation by Ocular Systems Incorporated (OSI). Visual outcomes were compared using graft thickness as a continuous variable. Visual outcomes were also compared between three groups: grafts 100 microns or less (n=29), grafts between 101 and 150 microns (n=137), and grafts 151 microns or greater (n=43). The Kruskal-Wallis test of difference in medians was used to determine significance.
The median visual change for grafts 100 microns or less was -0.204 LogMAR (standard deviation 0.503). The median visual change for grafts between 101 and 150 microns was also -0.204 LogMAR (standard deviation 0.477). The median visual change for grafts 151 microns or greater was -0.222 LogMAR (standard deviation 0.467). The difference in acuity between pre-operative vision and vision at the six month timepoint is not significantly different among the three thickness categories (p=0.835).
Analysis of visual outcomes six months following DSEK show no statistically significant difference based upon pre-operative graft thickness. Based upon the current analysis, current donor cornea graft preparation protocols do not need amending to favor a certain thickness. Additional analysis of visual outcomes at the one-year or two-year timepoints in this population is ongoing to determine if significant differences between thickness groups exist later in the course of graft maturity.
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