Abstract
Purpose: :
To evaluate the relationship between donor graft thickness and the incidence of primary graft failure or graft dislocation in Descemet’s stripping automated endothelial keratoplasty (DSAEK).
Methods: :
Twenty five consecutive microkeratome-cut DSAEK transplants of various thicknesses performed at a single institution were analyzed retrospectively.
Results: :
Post-operatively, there were seven DSAEK graft dislocations within the first week and three DSEK primary graft failures within the first two months. All of the primary graft failures were in the group of patients who received transplants of thicknesses less than 100 micrometers (P=0.004). Of the transplants that dislocated, two of five (40%) were less than 100 micrometers, one of seven (14%) were between 100 and 140 micrometers, and four of thirteen (31%) were greater than 140 micrometers. Although there was a trend towards dislocation in the grafts less than 100 micrometers or greater than 140 micrometers, this was not found to be statistically significant when compared with the transplants between 100 and 140 micrometers in thickness (P=0.72).
Conclusions: :
This case series suggests that there may be an ideal DSAEK donor graft thickness which may reduce the rate or primary graft failure and transplant dislocation.
Keywords: transplantation • cornea: clinical science • cornea: endothelium