Abstract
Purpose :
To describe and evaluate clinical outcomes obtained from eyes that underwent through DSAEK or DMEK performed by fellows in training
Methods :
Descriptive, retrospective study. Variables: age, ocular comorbidities and BCVA prior to the procedure and following the procedure at 1, 3, 6 and 12 months mark. Indications for surgery, donor endothelial cell count were taken into consideration. Analysis were performed with GraphPad Prism 9 (La Jolla, CA)
Results :
Fifty-six eyes were included. DSAEK was performed in 53 patients and DMEK in 3 patients. Median age in DSAEK was 70.58 (±10.10), being more prevalent in females. DSAEK alone was performed in 43 patients and 9 had DSAEK-phacoemulsification with intraocular lens implantation (phaco IOL). Main indication for DSAEK was Fuchs’ endothelial dystrophy (22.64%). There was no failure of found in 29 (54.71%) of the 53 patients and transplant failure in 24 (45.28%), 16 being primary failure (66.6%) and secondary failure in 8. Visual acuity (VA) was compared at 1-year follow-up by comparing it preoperatively, at 1, 3, 6, and 12 months in the groups with and without failure. A statistically significant difference (P<0.001) was found between preoperative VA and the rest of the measurements during the course of 1 year in patients without failure but no statistical significant difference in failure (P 0.1328)(Figure 1). The average endothelial count of the donors who presented failure was 2881.29 cells/mm2 while the endothelial count of those that did not present it was 2953.24 cells/mm2. No significant difference (p 0.4918) found between both groups. DMEK was performed in 3 patients with diagnosis of pseudophakic bullous keratopathy, Fuchs’ endothelial corneal dystrophy and endothelial failure from angle closure. Mean age was 70.33 years (±14.15). Average VA before DMEK was 1.33,0.96 after a month, 0.98 after 3 months, 1.35 after 6 months and 1.71 after a year(Figure 2)
Conclusions :
Results of posterior lamellar transplants performed by fellows in training are similar to those reported in the literature. Visual acuity improved during the 1-year follow-up, which indicates that DSAEK is a favorable technique for the treatment of any type of endothelial dysfunction. Although studies show better visual results with DMEK eligibility criteria in our population of patients for DMEK condition its performance, which is why DSAEK continues to be the most commonly used procedure
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.