Comparative analysis of corneal parameters between DMEK and UT‐DSAEK eyes in 3‐year follow‐up

Abstract

Aims/Purpose: The aim of the study was to provide a comparative analysis of corneal parameter changes compared to their preoperative values between Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT‐DSAEK) patients.Methods: The study included 27 eyes after UT‐DSAEK and 34 eyes after DMEK. Best corrected visual acuity (BCVA), endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA) and higher order aberrations (HOAs) were assessed at baseline and 1, 3, 6, 12, 24 and 36 months after the surgery.Results: Patients after DMEK had significantly better BCVA than patients after UT‐DSAEK (mean 0.9 vs. 0.6 at 24th month, respectively, p = 0.002 and 0.9 vs. 0.7 at 36th month of follow‐up, respectively, p = 0.001). From the 3rd month post operation, ECC was higher in the DMEK eyes than in the UT‐DSAEK eyes (p = 0.01). However, the groups did not differ in this parameter at 24th and 36th month of observation. In a bivariate analysis that was adjusted for age, DMEK was associated with a smaller decrease in posterior MK at the 1‐month (β = −0.49, p = 0.002), 3‐month (β = −0.50, p < 0.001), 6‐month (β = −0.58, p < 0.001) and 12‐month (β = −0.49, p < 0.001) follow‐up visits. Significant differences in MK, AA and HOA values of the posterior surface of the cornea at 12th, 24th and 36th month of observation and MA of the posterior surface of the cornea at 24th month of observation were found as well, with no differences in the total values of these parameters. Accordingly, no significant differences in changes in MA, AA or HOAs compared to the baseline values were identified between the eyes after DMEK and UT‐DSAEK at any follow‐up time point.Conclusions: UT‐DSAEK seem to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values. Nevertheless, DMEK produces significantly better BCVA outcomes.