Comparative Analysis of Corneal Parameters in Swept-Source Imaging between DMEK and UT-DSAEK Eyes.

Anna Machalińska,Agnieszka Kuligowska,Bogna Kowalska,Krzysztof Safranow

doi:10.3390/jcm10215119

Abstract

Background: The need 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 24 eyes after UT-DSAEK and 24 eyes after DMEK. Visual acuity, 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 and 12 months after the surgery. Results: From the 3rd month post operation, ECC was higher in the DMEK eyes than in the UT-DSAEK eyes (p = 0.01). 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. There were no significant differences in changes in anterior or combined surface MK throughout the observation period. 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 seemed to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values.

Highlights

The introduction of endothelial keratoplasty (EK) has revolutionized corneal transplantation over almost the past two decades
There were no significant differences between the groups in the values of corneal topographic parameters, i.e., the mean keratometry (MK) values, astigmatism power and asymmetry (AA) and the values of higher-order aberrations (HOAs)
We found that the baseline best-corrected visual acuity (BCVA) determined the postoperative corneal thickness at the 12-month follow-up in both the UT-Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) groups

Summary

Introduction

The introduction of endothelial keratoplasty (EK) has revolutionized corneal transplantation over almost the past two decades. There are only a few studies that compared DMEK and UT-DSAEK, and they mainly focused on visual acuity outcomes, contrast sensitivity, endothelial cell loss or complication rates [4,5,6,7,8,9,10]. Chamberlain et al documented that DMEK had superior visual acuity results with similar complication rates compared with UT-DSAEK at 3, 6 and 12 months post surgery in patients with isolated endothelial dysfunction [9]. 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 seemed to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values

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Conclusion