Clinical outcomes of DSAEK and modified (endothelium-inside roll) DMEK

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 09:26

Venue: Hall C1

First Author: : O.Antonova RUSSIA

Co Author(s): :    B. Malyugin   E. Malyutina                 

Abstract Details

Purpose:

To evaluate and compare visual outcomes of two types of endothelial keratoplasty techniques: Descemet’s stripping automated endothelial keratoplasty (DSAEK) and modified Descemet’s membrane endothelial keratoplasty (mDMEK)

Setting:

S. Fyodorov Eye Microsurgery State Institution, Moscow, Russia

Methods:

During DSAEK ultra-thin grafts were used prepared with the double-pass of microkeratome based on the donor pachymetry. Modified DMEK technique included fixating the corneo-scleral button endothelium up in the holder, partial trephination with Muraine punch (8.0mm), blunt dissection of the Descemet’s membrane (DM) with spatula, creating orientation marks at the edge of DM, rolling the DM with endothelium facing inwards, hydro-injecting the membrane, unfolding and fixating with air bubble. Best-corrected visual acuity (BCVA), endothelial cell density (ECD), corneal pachymetry, intraoperative and postoperative complications were evaluated before and 1, 3, 6 and 12 months after the surgery in both groups

Results:

During the surgery following complications were observed: 5cases of donor cornea perforation in Group1, 7cases in Group2. In the early postop period 4pupillary blocks were observed at Group1, 2cases of graft dislocation were observed (1at each Group). Preop BCVA in Group1 was 0,025±0,07, in Group2 - 0,15±0,13. 1 month postop BCVA was 0,45±0,16 and 0,67±0,17 in Groups 1 and 2 respectively. Postop mean ECD was 2245±194 cells/sq.mm in Group1, 1980±181 cells/sq.mm in Group2, pachymetry was 645±46μm in Group1 compared to 548±12μm in Group2. 12 month postop BCVA in Group1 was 0,63±0,23, in Group2 - 0,81±0,20; ECD 2070±154 cells/sq.mm and 1900±221 cells/sq.mm, pachymetry - 620±33μm, and 538±28μm respectively. Late complications: 1case of transplant rejection in Group1, 4cases of corneal decompensation in Group2

Conclusions:

Both techniques provided relatively fast visual rehabilitation, however the final BCVA was higher after mDMEK. However it was also associated with the higher rate of complications

Financial Disclosure:

NONE