Quality of vision after ultrathin Descemet's stripping automated endothelial keratoplasty (UT-DSAEK) and DSAEK, a randomized multicenter clinical trial

Session Details

Session Title: Cornea Surgical I

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

Paper Time: 08:06

Venue: Hall C1

First Author: : M.Dickman THE NETHERLANDS

Co Author(s): :    S. Dunker   P. Kruit   L. Remeijer   J. van Rooij   A. van der Lelij   R. Wijdh   F. van den Biggelaar   T. van den Berg

Abstract Details

Purpose:

Previously we reported UT-DSAEK results in better vision compared to DSAEK. In the current study we set out to assess and compare changes in vision-related quality-of-life and quality of vision in patients suffering from Fuchs’ endothelial dystrophy before and after UT-DSAEK and DSAEK.

Setting:

Randomized controlled double-blinded multicenter clinical trial in four tertiary ophthalmology clinics in the Netherlands.

Methods:

Sixty-six patients were examined before and 3, 6 and 12 months postoperatively. At each examination vision-related quality of life, contrast sensitivity, straylight, corneal backscatter, and corneal densitometry were measured using the 39-item National Eye Institute Visual Functioning questionnaire (NEI VFQ-39), CSV-1000 chart, C-Quant straylight meter, in-vivo-confocal-microscopy (IVCM) and Scheimpflug topography, respectively.

Results:

UT-DSAEK resulted in better contrast sensitivity (3 months: Log (CS) =1.07 vs. 1.34, p=0.017; 6 months: Log (CS) =1.11 vs. 1.47, p=0.004) and vision-related quality of life (12 months: 88.27 vs. 84.27 p< 0.05) compared with DSAEK. Straylight (3 months: β=-0.08, p<0.001; 6 months: β=-0.1, p<0.001; 12 months: β=-0.09, p<0.001), corneal backscatter (3 months: β=-0.13 p=0.044; 6 months β=-0.3, p<0.001; 12 months β=-0.3, p<0.001) and corneal densitometry (3 months: β=-0.22, p<0.001; 6 months β=-0.2, p<0.001; 12 months:-0.2, p<0.001) improved significantly postoperatively but did not differ between UT-DSAEK and DSAEK. Patient age correlated significantly with improvement in straylight, corneal backscatter and densitometry.

Conclusions:

UT-DSAEK results in better contrast sensitivity and vision-related quality of life compared with DSAEK. Straylight, corneal backscatter and densitometry improved significantly postoperatively irrespective of the technique. Younger patients showed greater improvement in straylight, corneal backscatter and densitometry supporting earlier intervention prior to the development of irreversible corneal changes.

Financial Disclosure:

NONE