Yakov Goldich1, Mahmood Showail2, Noa Avni-Zauberman2, Mauricio Perez2, Randall Ulate2, Uri Elbaz2, David S Rootman2. 1. University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada. Electronic address: doctor.goldich@gmail.com. 2. University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
Abstract
PURPOSE: To compare objective and subjective outcomes after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the fellow eye of the same patients. STUDY DESIGN: Single-center, retrospective case series. METHODS: Seventeen patients with bilateral Fuchs endothelial dystrophy who underwent DSAEK earlier in 1 eye, and later underwent DMEK in the contralateral eye, composed study population. A chart review was completed to obtain follow-up data for at least 6 months after each surgery. Outcome measures included best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD). Subjective questionnaires were used to assess patients' satisfaction. RESULTS: Preoperative BSCVA (logMAR) was similar in both groups, 0.66 ± 0.4 in DMEK and 0.59 ± 0.4 in DSAEK (P = .6). The DMEK group showed better BSCVA than the DSAEK group at the 6-month time point (0.25 ± 0.1 and 0.39 ± 0.1, for DMEK and DSAEK, respectively, P = .02). Preoperative ECD (cells/mm(2)) was similar in both groups (2647 ± 249 and 2768 ± 404, P = .3) in DMEK and DSAEK, respectively. There was statistically significant difference found in ECD at 6 months (2227 ± 565 for DMEK and 1780 ± 433 for DSAEK, P = .049). Subjective level of average satisfaction after DMEK was 6 and after DSAEK was 4.87 ± 1.19 (P = .002). CONCLUSIONS: DMEK provided better visual outcome and lower endothelial cell loss than DSAEK and a higher level of patient satisfaction when assessed at 6 months after surgery. Our results comparing the 2 procedures in the same patients support the benefits of DMEK, and suggest the need for long-term studies observing this new surgical procedure.
PURPOSE: To compare objective and subjective outcomes after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the fellow eye of the same patients. STUDY DESIGN: Single-center, retrospective case series. METHODS: Seventeen patients with bilateral Fuchs endothelial dystrophy who underwent DSAEK earlier in 1 eye, and later underwent DMEK in the contralateral eye, composed study population. A chart review was completed to obtain follow-up data for at least 6 months after each surgery. Outcome measures included best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD). Subjective questionnaires were used to assess patients' satisfaction. RESULTS: Preoperative BSCVA (logMAR) was similar in both groups, 0.66 ± 0.4 in DMEK and 0.59 ± 0.4 in DSAEK (P = .6). The DMEK group showed better BSCVA than the DSAEK group at the 6-month time point (0.25 ± 0.1 and 0.39 ± 0.1, for DMEK and DSAEK, respectively, P = .02). Preoperative ECD (cells/mm(2)) was similar in both groups (2647 ± 249 and 2768 ± 404, P = .3) in DMEK and DSAEK, respectively. There was statistically significant difference found in ECD at 6 months (2227 ± 565 for DMEK and 1780 ± 433 for DSAEK, P = .049). Subjective level of average satisfaction after DMEK was 6 and after DSAEK was 4.87 ± 1.19 (P = .002). CONCLUSIONS: DMEK provided better visual outcome and lower endothelial cell loss than DSAEK and a higher level of patient satisfaction when assessed at 6 months after surgery. Our results comparing the 2 procedures in the same patients support the benefits of DMEK, and suggest the need for long-term studies observing this new surgical procedure.
Authors: Meraf A Wolle; David L DeMill; Lauren Johnson; Stephen I Lentz; Maria A Woodward; Shahzad I Mian Journal: Cornea Date: 2017-11 Impact factor: 2.651