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Changes in macular thickness after Descemet's stripping automated endothelial keratoplasty

Poster Details

First Author: R.Shehadeh- Mashor ISRAEL

Co Author(s):    O. Nasser   W. Sansanayudh   D. Rootman   A. Slomovic     

Abstract Details



Purpose:

To assess changes in macular thickness after Descemet's stripping automated endothelial keratoplasty (DSAEK), using Optical coherence tomography

Setting:

Department of Ophthalmology, Toronto Western Hospital, University of Toronto, Toronto, Canada

Methods:

A prospective study comprised 33 eyes of 31 patients (17 females, 16 males) who had Fuchs dystrophy or pseudophakic bullus keratopathy (PBK) and underwent DSAEK or combined DSAEK with cataract surgery between April 2008 and April 2010 .All patients underwent a full ophthalmologic examination, including uncorrected visual acuity (UCVA), Best corrected visual acuity (BCVA),manifest refraction, slit-lamp biomicroscopy, fundus examination through dilated pupils and macular thickness measurement using OCT(Carl Zeiss Meditec, Inc, Dublin, California, USA) preoperatively and 1 and 3 months postoperatively.

Results:

There were 7, 9 eyes with Fuch's endothelial dystrophy and Pseudophakic bullous keratopathy (PBK), respectively that underwent DSAEK , 17 eyes with Fuch's endothelial dystrophy and cataract that underwent combined DSAEK with phacuemulsification cataract surgery. For the whole group there was a significant increase of 19.32 micron in macular thickness at 1 month after surgery (P=0.025). At 3 months the increase of 10.33 was not statistically significant (p=0.192). For the Fuch's endothelial dystrophy there was a mean increase of 11.83 and a mean decrease of 9 microns at 1 and 3 months, respectively. For the PBK group there was 12.37 and 2.428 micron at 1 month (P=0.603) and at 3 months after surgery (P=0.883), respectively. These changes were not significant. For the Fuch's endothelial dystrophy and cataract group there was a significant increase of 26.50 micron at 1 month (P=0.012) and 23.15 at 3 months after surgery (P=0.038).

Conclusions:

Macular thickness significantly increased after DSAEK combined with cataract surgery but didn't change significantly when only DSAEK was performed.Therefor, in addition to its known advantages in minimizing wound and suture related complications as well as postoperative astigmatism, DSAEK might also provide additional advantage by minimizing macular edema after surgery. FINANCIAL INTEREST: NONE

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