Corneal densitometry after DMEK vs DSAEK: two-year results

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Sunday 08/10/2017 | 10:30-12:30

Paper Time: 11:22

Venue: Meeting Center Room I

First Author: : K.Droutsas GREECE

Co Author(s): :    A. Lazaridis   E. Giallouros   G. Kymionis   W. Sekundo           

Abstract Details

Purpose:

To analyze and compare corneal densitometry (CD) after Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK).

Setting:

Department of Ophthalmology, Philipps-University, Marburg, Germany and the First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece

Methods:

Medical records of consecutive DMEK and DSAEK cases (130 and 49 eyes, respectively) were reviewed. A total of 54 DMEK (group 1) and 25 DSAEK cases (group 2) were included after excluding eyes with prior corneal surgery, complicated intraoperative or postoperative course and vision-limiting ocular comorbidities. Age-matched pseudophakic eyes were also included as controls (group 3; n=20). Scheimpflug CD of the optically relevant zones (0-2mm and 2-6mm), best-corrected visual acuity (BCVA) endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated preoperatively and at 3, 6, 12 and 24 months postoperatively.

Results:

CD was significantly lower after DMEK compared to DSAEK at 3 and 6 months (P≤0.012), however similar between the two techniques at 12 and 24 months after surgery (P≥0.056). Postoperative BCVA was significantly higher after DMEK for every examination time point (P<0.001). ECD was similar in both groups (P≥0.081). Regression analysis showed an inverse relationship between BCVA and CD after DMEK (P<0.024). However, no statistically significant correlation was found between BCVA and CD after DSAEK (P≥0.39). Finally, the 24-month CD values were similar between the DMEK group and healthy pseudophakic controls (P=0.152).

Conclusions:

CD was lower and BCVA higher after DMEK compared to DSAEK in the first 6 postoperative months. Interestingly, while CD reached similar levels in the midterm after both DMEK and DSAEK, BCVA remained significantly better after DMEK.

Financial Disclosure:

NONE