Quality of vision after ultra-thin Descemet's stripping automated endothelial keratoplasty (UT-DSAEK) vs Descemet's membrane endothelial keratoplasty (DMEK): a multicentre randomised controlled clinical trial

Session Details

Session Title: Cornea Surgical: Lamellar Corneal Grafts

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 10:12

Venue: Free Paper Forum: Podium 3

First Author: : S.Dunker THE NETHERLANDS

Co Author(s): :    M. Dickman   R. Wisse   S. Nobacht   R. Wijdh   M. Bartels   R. Nuijts   M. Tang   F. van den Biggelaar   P. Kruit     

Abstract Details

Purpose:

To compare quality of vision and vision-related quality of life after UT-DSAEK versus DMEK.

Setting:

The study was carried out in four tertiary, and two secondary hospitals in the Netherlands. Precut UT-DSAEK and pre-stripped DMEK grafts were prepared by a single eye bank.

Methods:

Straylight, contrast sensitivity and vision-related quality of life (VRQOL) were measured using the C-Quant straylight meter (OCULUS Optikgeräte GmbH, Wetzlar, Germany), CSV-1000 chart (Vector vision Inc., Greenville, OH, USA) and the composite score of the 25-item National Eye Institute Visual Functioning Questionnaire (VFQ-25), respectively. Data were analyzed using the Student’s t-test for differences between groups. Results are shown as means with standard deviation. We considered a two-sided P-value of less than 0.05 statistically significant.

Results:

Preoperative straylight measured log(s)=1.66±0.31 and log(s)=1.52±0.24 in the DMEK and UT-DSAEK arm, respectively. Three months after surgery, straylight was significantly lower after DMEK compared to UT-DSAEK (log(s)=1.32±0.22 vs. log(s)=1.48±0.24; P=0.03), and comparable thereafter. Preoperative contrast sensitivity measured log(cs)=0.71±0.25 and log(cs)=0.65±0.24 in the DMEK and UT-DSAEK arm, respectively. Three months postoperatively, contrast sensitivity was significantly higher after DMEK compared to UT-DSAEK (log(cs)=1.22±0.34 vs. log(cs)=0.97±0.3; P=0.01, and comparable thereafter. Preoperative VRQOL measured 69±14 and 69±13 in the DMEK and UT-DSAEK arm, respectively. Three months after surgery, VRQOL was comparable between DMEK and UT-DSAEK (80±11 vs. 78±15; P=0.49), stabilizing thereafter in both groups

Conclusions:

DMEK results in faster recovery of contrast sensitivity and straylight compared to UT-DSAEK. However, six and twelve month after surgery straylight and contrast sensitivity are comparable between both techniques. Vision-related quality of life is comparable between both techniques at all time-points.

Financial Disclosure:

None