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Donor lenticule thickness not a significant factor in DSAEK outcome
Cornea. 2011;30(11):1195-1200.
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Surgeons should focus on minimizing surgical trauma to donor lenticules rather than striving for a specific depth when cutting the graft, a study found, because lenticule thickness has no direct effect on postop visual acuity or endothelial cell density at 6 months after Descemet's stripping automated endothelial keratoplasty.
The prospective case series examined 37 eyes of 35 patients, aged 44 to 73, undergoing DSAEK. Lenticule thickness was measured via ultrasound pachymetry and evaluated regarding best corrected visual acuity and endothelial cell density at 6 months postop. Three eyes were not included in the 6-month BCVA analysis.
At 6 months, all patients demonstrated significant improvements in BCVA. LogMAR BCVA improved from a mean of 0.58 ± 0.20 before treatment to 0.29 ± 0.16 (P < .0001). Mean endothelial cell loss was 39%.
"Our data suggest that the intraoperative donor pachymetry is not related to the 6-month [endothelial cell density] or BCVA," the study authors wrote. "Therefore, it is advisable to err on the side of technical ease when preparing the donor tissue to avoid donor perforation or other complications."
Study limitations included small sample size and the potential for weak correlation between intraoperative and postoperative thickness because of variable levels of hydration.