June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Change in Central and Peripheral Corneal Thickness in UT-DSAEK and DMEK in the Descemet Endothelial Thickness Comparison Trial
Author Affiliations & Notes
  • Michal Gutowski
    Ophthalmology, OHSU Casey Eye Institute , Portland, Oregon, United States
  • Jennifer Rose-Nussbaumer
    UCSF, San Francisco, California, United States
  • Charles Lin
    Stanford University, Palo Alto, California, United States
  • Ariana Austin
    Francis I. Proctor Foundation, University of California, San Francisco, California, United States
  • Paula Labadzinzki
    Ophthalmology, OHSU Casey Eye Institute , Portland, Oregon, United States
  • Jameson Clover
    Lions VisionGift, Portland, Oregon, United States
  • Winston Chamberlain
    Ophthalmology, OHSU Casey Eye Institute , Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Michal Gutowski, None; Jennifer Rose-Nussbaumer, None; Charles Lin, None; Ariana Austin, None; Paula Labadzinzki, None; Jameson Clover, None; Winston Chamberlain, None
  • Footnotes
    Support  NIH grant K23 EY025025 (J.N.), P30EY010572 (CEI departmental core grant), Unrestricted grant (UCSF and CEI) from Research to Prevent Blindness (New York, NY), Lions VisionGift (Portland, OR)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3567. doi:
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      Michal Gutowski, Jennifer Rose-Nussbaumer, Charles Lin, Ariana Austin, Paula Labadzinzki, Jameson Clover, Winston Chamberlain; Change in Central and Peripheral Corneal Thickness in UT-DSAEK and DMEK in the Descemet Endothelial Thickness Comparison Trial. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3567.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Differential changes in corneal and graft shape after endothelial keratoplasty may effect post-operative vision and refraction. The changes in ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet Membrane Endothelial Keratoplasty (DMEK) graft and host corneal thickness over time have not been examined in a randomized controlled trial. We compared central and peripheral corneal thickness over time following UT-DSAEK and DMEK in the Descemet Endothelial Thickness Comparison Trial (DETECT).

Methods : A total of 50 eyes of 38 patients with isolated endothelial dysfunction from Fuchs endothelial dystrophy or pseudophakic bullous keratopathy were randomized to receive DMEK or UT-DSAEK. Central (0-0.3 mm from center), mid peripheral (1.4-1.6 mm), and peripheral (2.7-3.0 mm) host and graft corneal thickness data were obtained using anterior segment OCT (Optovue RTVue-XR®) with a horizontal line scan approximately mid pupil at 3 months and 12 months post-operatively. Paired T-tests were used to compare graft and host corneal thickness at each time point in 19 UT-DSAEK eyes and 19 DMEK eyes.

Results : After UT-DSAEK at 3 months (p=0.002) and 12 months (p =0.03), there was statistically significant central graft thickening compared to baseline graft thickness. There was no significant change in mid peripheral (p=0.25) and peripheral (p=0.22) graft thickness between 3 months and 12 months post-operatively. There was no difference in host central (p=0.92) or mid peripheral (p=0.27) cornea thickness at 3 months and 12 months. There was statistically significant host cornea peripheral thinning at 12 months compared to 3 months post-operatively (p=0.001). By comparison, there was no significant change after DMEK in central (p=0.25) and peripheral (p=0.22) corneal thickness between 3 and 12 months post-operatively.

Conclusions : 3 and 12 months following UT-DSAEK, central graft thickness increased compared to pre-surgical values. Peripheral host cornea thickness decreased at 12 months compared to 3 months following UT-DSAEK while peripheral graft thickness did not change. There was no significant change between 3 and 12 months in central or peripheral corneal thickness after DMEK. Differential changes in thickness may effect corneal optics.

This is a 2020 ARVO Annual Meeting abstract.

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