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Thin and ultrathin DSEK: is it just thickness that matters?

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Session Details

Session Title: Presented Poster Session: Cornea I

Venue: Poster Village: Pod 3

First Author: : M.Tsatsos UK

Co Author(s): :    A. Turnbull   D. Anderson   P. Hossain        

Abstract Details


To determine the predictability of the relationship between graft thickness, time, ocular pathology, host characteristiscs and visual acuity after manual Descemet Stripping Endothelial Keratoplasty (DSEK).


Southampton University Hospitals Aristotelian University of Thessaloniki


Prospective non-randomised consecutive case series of 53 patients undergoing TMDSEKFuchs’ endothelial dystrophy (FED) or pseudophakic bullous keratopathy (PBK).Patients with other vision limiting pathology were excluded. The impact of graft thickness on log (Mar Visual Acuity) is investigated by utilizing linear regression analysis after controlling for the effect of patients’ gender, age, time after operation, diagnosis type and operation type. All parametric analyses descriptive statistics, Correlation between graft thickness, total corneal thickness and visual acuity and linear regression analyses were performed using SPPS v2310.


Strong, statistically significant positive correlation was found between BCVA and Graft Thickness (GT) (r=0.619, Pearson correlation coefficient; p<0.001) (Figure 4). Moderate, statistically significant positive correlation was found between BUCVA and total Corneal Thinckness(CT) (r=0.471; p<0.001). Graft thickness alone explains 41.0% of the variability of logMAR BCVA. The addition of time evolution to the model increased its predictive ability to 45.6 % (p=0.005). The inclusion of the diagnosis (FED or PBK) and type of operation (primary, combined or redo) variables resulted in no change in the model's performance


Our results demonstrate the relative importance of GT in determining visual outcomes, with GT accounting for 41.0% of the total variability in BCVA. Other variables including CT or underlying diagnosis had less of an impact. The observation that over 50% of the visual outcome was not accounted for by the variables included in this study confirms that the determinants of BCVA from DSEK are multi-factorial. GT is important, but does not offer the complete answer. Although determinants of visual outcomes after DSEK are multifactorial and complex graft thickness accounts for a substantial proportion of the variability in BCVA following DSEK

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