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First Author: P.Fournié FRANCE
Co Author(s): J. Arné F. Malecaze
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To compare different techniques of corneal endothelial transplantation: Descemet stripping automated endothelial keratoplasty (DSAEK), thin-DSAEK, and Descemet membrane endothelial keratoplasty (DMEK).
Service dOphtalmologie, Hôpital Purpan, Toulouse, France.
Seventy-two eyes of patients underwent a DSAEK with a single cut at 350 microns, 31 eyes underwent a thin-DSAEK with a double cut, and 10 eyes underwent a DMEK. Visual acuity, refractive outcomes, postoperative graft thickness (OCT), endothelial cell count, intra- and post-operative complications were analyzed with at least a 6-month follow-up.
Mean graft thickness was 165.25 ±36.58 microns (95 to 225 microns) in the DSAEK group and 123.65 ±16,45 microns (65 to 145 microns) in the thin DSAEK group (p<0.05). Visual acuity was not different between DSAEK and thin-DSAEK (p>0.05) with 25% of patients with at least 20/25. Visual acuity was better after DMEK (p<0.05) with 62.5% of patients with at least 20/25. Postoperative graft detachment was 14% in the DSAEK group versus 65% after DMEK.
Postoperative graft thickness may not explain alone the better visual acuity reported after DMEK. However, these promising results are tempered by the technical difficulty with unrolling and orienting the DMEK tissue. Longer follow-up and a larger number of patients are expected for comparative purposes.