London 2014 Registration Visa Letters Programme Satellite Meetings Glaucoma Day 2014 Exhibition Hotel Booking Virtual Exhibition Star Alliance
london escrs

Course handouts are now available
Click here

Come to London


WATCH to find out why

Site updates:

Programme Updates. Programme Overview and - Video Symposium on Challenging Cases now available.

Preliminary results of a multicenter prospective randomized controlled trial comparing ultra-thin and standard thickness Descemet's stripping automated endothelial keratoplasty (DSAEK)

Search Abstracts by author or title
(results will display both Free Papers & Poster)

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 08:18

Venue: Boulevard B

First Author: : M.Dickman THE NETHERLANDS

Co Author(s): :    J. Van Rooij   L. Remeijer   G. Van der Lelij   R. Wijdh   F. Van Marion   R. Nuijts

Abstract Details


To compare the effectiveness of pre-cut ultra-thin (UT) with pre-cut standard thickness DSAEK. Outcome measures included best corrected ETDRS visual acuity and endothelial cell density.


The study took place in four academic medical centers in The Netherlands:University Eye Clinic Maastricht, Rotterdam Eye Hospital, University Medical Center Groningen and University Medical Center Utrecht. Donor corneas were pre-cut by the Euro Cornea Bank, Beverwijk,The Netherlands.


Fifty-eight patients were randomly assigned to either standard-thickness or UT-DSAEK. Eligible participants were all 18 years or older with Fuchs endothelial dystrophy and no other vision limiting comorbidities. Exclusion criteria were previous corneal transplantation in the study eye and HLA-typed transplantation. Randomisation criteria included EDTRS best-corrected-visual-acuity (BCVA), preoperative recipient central corneal thickness, age and center. Donor corneas were pre-cut using the Gebauer SLc microkeratome system. Lamellar thickness was measured using ocular-coherence-tomography, followed by ECD evaluation. Patients were evaluated preoperatively, 3-months, 6-months and 1-year postoperatively. BCVA was measured using a standardized ETDRS chart and ECD was manually measured by specular microscopy.


Mean patient age was 71±10 years. Mean lamellar thickness measured 95±30µm (95%C.I. 83-100) in the UT group and 217±34µm (95%C.I. 203-231) in the standard group. Preoperatively, BCVA did not differ between both groups (0.35±0.2logMAR, p=0.93). Three months postoperatively, BCVA was significantly better in the UT group (0.11±0.1logMAR) compared with the standard group (0.28±0.1logMAR, p<0.001). BCVA remained significantly better in the UT group (0.07±0.06logMAR) at 6 months compared with the standard group (0.26±0.11logMAR, p<0.001). ECD did not differ between groups at all time points and measured 2667±143 cells/mm2 preoperatively, 1523±224 cells/mm2 at 3 months and 1483±226 cells/mm2 at 6 months.


The preliminary outcomes of our randomized controlled trial indicate that BCVA following pre-cut UT-DSAEK improves faster and remains significantly higher compared with standard pre-cut DSAEK with a similar endothelial cell loss. We expect these results to be generally applicable in the clinical setting to the benefit of patients.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

Back to previous