Comparative evaluation of visual quality in DMEK and ultra-thin DSAEK and correlation with lenticule thickness

Session Details

Session Title: Presented Poster Session: Spotlight on Cornea

Venue: Poster Village: Pod 2

First Author: : J.Titiyal INDIA

Co Author(s): :    M. Kaur   F. Shaikh                    

Abstract Details

Purpose:

To compare visual quality in cases undergoing Descemet's membrane endothelial keratoplasty (DMEK) and ultra-thin Descemet's stripping automated endothelial keratoplasty (DSAEK).

Setting:

Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi.

Methods:

Prospective interventional study of cases with corneal decompensation undergoing DMEK (n=18) or ultra-thin DSAEK (n=19). Primary outcome measure was visual quality [modulation transfer function (MTF) and higher order aberrations (HOA)] assessed by ray tracing aberrometry. Secondary outcome measures were visual acuity and graft survival. Follow-up was performed on postoperative day 1 and 1, 3, 6 and 12 months.

Results:

At one year, donor lenticule thickness was 16.3 ± 10.2 µm in DMEK group and 96.4 ± 37.37 µm in DSAEK group. MTF was significantly better after DMEK [DMEK: 0.185 ± 0.08; DSAEK: 0.109 ± 0.056, p=0.003]. Total HOA [DMEK- 0.859 ± 0.952 µm; DSAEK- 2.23 ± 2.44 µm; p=0.031] and coma [DMEK- 0.515 ± 0.561 µm; DSAEK- 1.191 ± 1.305 µm, p=0.032] were less in DMEK group . Lenticule thickness correlated negatively with MTF (Pearson correlation coefficient -0.571, p<0.001) and positively with total HOAs (Pearson correlation coefficient 0.483, p=0.002). Visual acuity and graft survival were comparable between two groups (p>0.05).

Conclusions:

Visual quality is significantly better after DMEK than ultra-thin DSAEK, with comparable visual acuity and graft survival. Donor lenticule thickness correlates with visual quality, with thinner lenticules associated with better contrast (MTF) and less HOAs.

Financial Disclosure:

None