Abstract

To assess changes in macular thickness after Descemet stripping automated endothelial keratoplasty (DSAEK), using optical coherence tomography. Prospective interventional case series. setting: Institutional. patients and intervention: Thirty-three eyes of 31 patients who had Fuchs dystrophy or pseudophakic bullus keratopathy (PBK) and underwent DSAEK or combined DSAEK with cataract surgery. main outcome measure: Changes in macular thickness. There were 7 eyes with Fuchs endothelial dystrophy and 9 eyes with pseudophakic bullous keratopathy (PBK) that underwent DSAEK, and 17 eyes with Fuchs endothelial dystrophy and cataract that underwent combined DSAEK with phacoemulsification cataract surgery. For the whole group there was a significant increase of 19.32 μm in macular thickness at 1 month after surgery (P = .025). At 3 months the increase of 10.33 μm was not statistically significant (P = .192). For the Fuchs endothelial dystrophy there was a mean increase of 11.83 μm and a mean decrease of 9 μm at 1 and 3 months, respectively. For the PBK group there was an increase of 12.37 μm and 2.428 μm at 1 month (P = .603) and at 3 months after surgery (P = .883), respectively. These changes were not significant. For the Fuchs endothelial dystrophy and cataract group there was a significant increase of 26.50 μm at 1 month (P = .012) and 23.15 μm at 3 months after surgery (P = .038). Macular thickness significantly increased after DSAEK combined with cataract surgery but did not change significantly when only DSAEK was performed.

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