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Study: DSAEK offers same benefits, better visual outcomes as other keratoplasty techniques

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While Descemet's stripping automated endothelial keratoplasty does not significantly alter refractive astigmatism or average topographic keratometry, the surgical technique can significantly improve vision, corneal thickness and surface regularity, a large, prospective study suggests.

"This newer technique of endothelial keratoplasty yields many of the benefits of its predecessors, deep lamellar endothelial keratoplasty and posterior lamellar keratoplasty, while improving the visual results," the study authors said.

Edwin S. Chen, MD, and colleagues evaluated 6-month visual outcomes after performing DSAEK on 150 eyes between September 2005 and October 2006. During the procedure, peripheral scraping was performed to promote donor adherence. The surgeons placed an automated microkeratome-prepared 8-mm endothelial graft through a 5-mm scleral-limbal incision. Best corrected visual acuity, uncorrected visual acuity, refractive astigmatism, average topographic keratometry, surface asymmetry index, surface regularity index and pachymetry were measured at baseline and at 6 months' follow-up.

Of these 150 eyes, 100 eyes were available for examination at 6 months.

At follow-up, average BCVA had improved from 20/86 to 20/38, and average UCVA had improved from 20/155 to 20/73 (P < .05 for both), the authors reported.

Excluding 26 eyes with identified retinal pathologies, 97% of the remaining 74 eyes had achieved a visual acuity of 20/40 or better, and 14% had achieved a visual acuity of 20/20 or better.

On average, refractive astigmatism had changed 0.06 D, and average topographic keratometry had changed an average of –0.13 D, the researchers noted.

At final follow-up, surface regularity index and surface asymmetry index had improved to normal levels of 0.67 and 1.03, respectively (P < .001 and P = .002).

In addition, pachymetry decreased from 0.7 mm to 0.66 mm (P = .001), according to the study, published in the June issue of Cornea.