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Micro-thin DSAEK improves vision with low risk of graft detachment
Micro-thin Descemet’s stripping automated endothelial keratoplasty yielded visual outcomes comparable to those of other endothelial keratoplasty techniques using thin grafts, according to a study.
The prospective study included 130 eyes of 114 patients who underwent micro-thin DSAEK; 53% of cases underwent combined phacoemulsification and DSAEK.
Eighty percent of cases were treated for Fuchs’ endothelial dystrophy.
Pachymetry-controlled stromal dehydration was performed to reduce donor thickness to 530 µm to 550 µm, and a single-pass microkeratome dissection was then used to create micro-thin endothelial grafts of less than 130 µm.
Donor corneas measured with ultrasound pachymetry after epithelial removal had a mean thickness of 590 µm (range: 485 µm to 806 µm). Pachymetry-controlled donor pre-conditioning reduced donor central corneal thickness by an average of 67 µm to 528 µm (P < .01). No cases of intraoperative graft loss or perforation were reported.
Mean central graft thickness was 95 µm after the cut, 94 µm intraoperatively and at 1 month, and 90 µm at 6 months and 12 months.
Snellen best corrected visual acuity was 6/9 in 98.2% of eyes without significant visual comorbidity at 12 months.
Endothelial cell density decreased 35.8% at 3 months and 41% at 12 months.
Five percent of cases experienced postoperative graft detachment. – by Matt Hasson
Disclosure: The authors report no relevant financial disclosures.
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Roberts HW, et al. Cornea. 2015;doi:10.1097/ICO.0000000000000596.