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Naïla Houmad, Oualid Guechi, piotr krawczyk, Mohamed Zaidi, Nadia OUAMARA, Alix EHRHARDT, Maxime SOT, Louis Lhuillier, adina agapie, Jean-Marc Perone, Huong Duong Nguyen Viet; Higher-order aberrations after DSEAK, "thin" DSEAK and DMEK: comparative study about 60 cases. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1907. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to assess the visual acuity after corneal graft by descemet’s stripping automated endothelial keratoplasty (DSAEK) or Descemet’s membrane endothelial keratoplasty (DMEK) for advancedendothelial dysfunction. Clinical data and higher-order aberrations (HOA) were analyzed.
A total of 60 eyes were included in our study and were divided into 4 groups: 15 DMEK (group 1), 15 “thin” DSAEK (group 2), 15 DSAEK (group 3) and 15 control eyes (group 4) which received no treatment. "Thin" DSAEK was defined as a graft with postoperative thickness inferior to 100μm. Surgeries were performed at Regional Hospital Center of Metz-Thionville (Mercy Hospital). In addition to the analysis of general clinical data, HOAs were measured by Scheimpflug camera (Schwind Sirius) one year after surgery for DSAEK and “thin” DSAEK , and six months after DMEK. Best spectaclecorrected visual acuity (BSCVA; in logarithm of the minimal angle of resolution [logMAR] units) was obtained. Data were compared between thefour groups.
The Mean increase of BSCVA was 0.64±0.56 logMAR for DMEK, 0.74±0.58 logMAR for DSAEK and 0.61±0.39 logMAR for "thin" DSAEK. There was no statistically significant difference for the gain line average. However post-op BSCVA in DMEK group was statistically higher than that in DSAEK group (p=0.017), but had no statistical difference with "thin" DSAEK group (p=0.31). For HOAs, the total and posterior root mean square (RMS) at 4 mm was statistically different (p<0.05) between controls and others groups. The back corneal RMS of the DMEK group is statistically lower than that of the DSAEK group (p=0.035) and “thin” DSAEK group (p=0.037). The difference between “thin” DSAEK and DSAEK was not significant (p=0.24).
As we show in our study, DMEK provided better visual recovery than DSAEK. Several comparative studies ended to the same result. The explanations usually moved forward to explain this difference include: hyperreflectivity of the interface, hyperopic shift and HOAs. Our series tends to confirm this last point. DMEK surgery seems to generate lower HOAs values than “thin” DSAEK and DSAEK, but more than in control group, concerning posterior RMS at 4 mm.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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