Postoperative visual acuity for DSAEK and UT-DSAEK: Is thinner better?

Abstract

Purpose : To study the correlation between graft size in DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) and UT (ultra-thin)-DSAEK type corneal transplants to the visual acuity 6 months postoperatively.

Methods : We conducted a prospective observational study, which included 111 patients who underwent DSAEK surgery in our department between February 2012 and June 2017.
Two groups were analyzed: respectively, UT-DSAEK with graft thickness at 6 months less than 100 μm ( group 1) and DSAEK with graft thickness more than 100μm (group 2). All surgeries were performed by the same surgeon and according to the same protocol. Pachymetry at 6 months was measured with the same device (OCT NIDEK RS 3000). Our primary endpoint was postoperative visual acuity in logmar at 6 months.

Results : We had 74 women (67%) and 27 men (33%) with a mean age of 76 years (SD 11). Group 1 was composed of 51 patients (46%) and group 2 of 60 patients (54%).
There is no significant difference between the two groups regarding sex, age and preoperative visual acuity. The average preoperative visual acuity was 1.31 logmar (SD 0.48) and 0.76 logmar (SD 0.54) at 6 months.
There is a correlation between visual acuity at 6 months and graft thickness (r = 0.24, p = 0.01). There is also a strong correlation between preoperative and postoperative visual acuity (p <0.001). Multivariate analysis showed that grafts less than 100 μm have better visual acuity at 6 months regardless of preoperative visual acuity: the difference was 0.19 logmar adjusted on preoperative visual acuity, age and sex (p = 0.04).

Conclusions : Patients who underwent on UT-DSAEK had better visual acuity at 6 months postoperatively, regardless of preoperative visual acuity. Those with better preoperative visual acuity also had better visual acuity at 6 months.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.