ESCRS - PP08.01 - Surgical Outcome Of Ultrathin Dsaek (Ut-Dsaek) Or Dmek Combined With Cataract Surgery For Fuchs’ Endotelial Dystrophy. Interim Data From A Randomized Controlled Clinical Study.

Surgical Outcome Of Ultrathin Dsaek (Ut-Dsaek) Or Dmek Combined With Cataract Surgery For Fuchs’ Endotelial Dystrophy. Interim Data From A Randomized Controlled Clinical Study.

Published 2022 - 40th Congress of the ESCRS

Reference: PP08.01 | Type: ESCRS 2022 - Posters | DOI: 10.82333/y582-gn55

Authors: Anders Ivarsen* 1 , Morten Madsen 1 , Jesper Hjortdal 1

1Ophthalmology,Aarhus University Hospital,Aarhus N,Denmark

Purpose

To examine the refractive outcome and endothelial cell density (ECD) after UT-DSAEK or DMEK with concurrent cataract surgery.

Setting

Department of Ophthalmology, Aarhus University Hospital, Denmark. 

 

Methods

The present report details interim 3- and 6-months data from a planned one-year study. Patients with Fuchs’ endothelial dystrophy and cataract were randomized to either UT-DSAEK (thickness < 100µm) or DMEK with concurrent cataract surgery. Examinations included subjective refraction, corneal tomography (Pentacam HR), and specular microscopy. Three- and six-months data was available for 49 patients (22 UT-DSAEK and 27 DMEK).

Results

UT-DSAEK caused a hyperopic shift of 1.19±0.94 D that was higher than the 0.57±0.74 D caused by DMEK (P<0.01). The corneal surface flattened 0.81±0.95 D (p<0.01) after UT-DSAEK and 0.39 ± 0.77 D (p=0.02) after DMEK. Similarly, the posterior corneal surface steepened 1.15 ± 0.51 D (p<0.01) after UT-DSAEK and 0.85 ± 0.52 D after DMEK (p<0.01). Changes in corneal shape were stable from 3 to 6 months. UT-DSAEK and DMEK caused a similar surgical induced astigmatism of 0.93 ± 0.60 D and 0.82 ± 0.78 D, respectively (ns).

ECD was significantly lower after UT-DSAEK than after DMEK averaging 1087 ± 469 mm-2 and 1524 ± 566 mm-2, respectively after 3 months (p<0.01). From 3 to 6 months, no significant change in ECD was observed after either procedure.

Conclusions

Phacoemulsification and UT-DSAEK had a poorer refractive outcome than phacoemulsification and DMEK. Both procedures showed a relatively large refractive change at the corneal back surface, that partly may be due to changes in corneal deturgescence. Approximately two-thirds of the postoperative hyperopic shift could be explained by a moderate change in anterior corneal power. Surgical induced astigmatism was similar after both procedures. Postoperative ECD was significantly worse after UT-DSAEK than after DMEK.