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domenico schiano lomoriello, Simona Venanzio, Rossella Annamaria Colabelli Gisoldi, Nicoletta Boni, Augusto Pocobelli; Corneal backscatter before and after Descemet membrane endothelial keratoplasty (DMEK). Invest. Ophthalmol. Vis. Sci. 2017;58(8):5699.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate and compare the corneal changes using in vivo confocal microscopy (IVCM) in patients affected by Fuchs’ dystrophy who underwent Descemet membrane endothelial keratoplasty (DMEK) or Descemet automated endothelial keratoplasty (DSAEK) and to evaluate the relationship between these changes and the postoperative visual recovery up to 6-months follow-up.
Methods: 20 eye of 20 pseudophakic patients underwent corneal endothelial surgery were divided in two groups (10 DMEK and 10 DSAEK). All patients underwent a complete ophthalmological evaluation including best corrected visual acuity (BCVA) and IVCM (subepithelial haze, interface haze, Z-scan curve) preoperatively and at 1 and 6 months postoperatively.
Results: Z-scan curve profile changes dramatically at 1 and 6 months if compared with preoperative in both groups . Patients of DSAEK group showed a corneal backscatter Z-scan curve with several peaks of hyper-reflectivity. Particularly in correspondence of the interface between the donor and recipient tissue there was in all the patient of the DSAEK group a peak of hyper-reflectivity. Another peak of iper-reflectivity was present in this group at subepitelial level (sub-epithelial haze) Patients of the DMEK group showed an hyper-reflectivity limited to the subepithelial haze. No deep hyper-reflectivities were noted in this group.Preoperative subepithelial haze was in comparable in both groups (r = 0.68 and r = 0.64, in DSAEK and DMEK group respectively , P = 0.001). At 6 months postoperatively interface haze was present only in the DSAEK group (r = 0.48, P 0.001). Postoperative subepithelial haze (r = 45 and r = 0.39, in DSAEK and DMEK group respectively P = 0.001) was comparable in both groups at 6 months. Visual recovery at 6 months was higher in DMEK (0,9) than the DSAEK group (0,6) (p <0,01).
Conclusions: The study confirmed that corneal interface haze is an important factor limiting visual acuity after DSAEK, suggesting that DMEK is the first choice in patients with Fuchs’ endothelial dystrophy to obtain a better corneal transparency.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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