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Descemet's membrane endothelial keratoplasty vs Descemet stripping automated endothelial keratoplasty in vitrectomized eyes

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First Author: M.Mimouni CANADA

Co Author(s):    N. Sorkin   J. Slomovic   E. Kisilevsky   T. Trinh   D. Rootman   A. Slomovic     

Abstract Details

Purpose:

To compare long term outcomes of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in vitrectomized eyes.

Setting:

Retrospective chart review conducted at the Toronto Western Hospital, Toronto Canada, a Tertiary Medical Center.

Methods:

This study included consecutive vitrectomizd patients that underwent either DMEK or DSAEK with at least 1 year of follow-up. All surgeries were performed by one of two experienced surgeons. The main outcome measures were best-corrected visual acuity (BCVA) and serious adverse events. Secondary outcomes included rates of rebubbling.

Results:

Fifty-two eyes of 52 patients with a mean age of 71.5±15.1 years were included. Mean follow-up time was 24.6±7.4 months. The DMEK group had a significantly larger proportion of Fuchs’ patients (p=0.009). There was no significant difference in postoperative logMAR BCVA between groups at each visit (p>0.05 for all). There was a significantly higher proportion of overall serious adverse events (50.0% versus 15.4%,p=0.008), retinal detachments (19.2% versus 0.0%,p=0.02) and cystoid macular edema (23.1% versus 0.0%, p=0.009) following DMEK. There were no significant differences in rebubbling rates (23.1% versus 11.5%,p=0.27).

Conclusions:

A significant and similar improvement in BCVA was achieved following DMEK and DSAEK in vitrectomized eyes. Patients should be advised regarding the higher rates of serious complications associated with a DMEK in this situation.

Financial Disclosure:

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