Eye Bank Pre-Stripped Versus Surgeon-Stripped Graft For Descemet Membrane Endothelial Keratoplasty: A Systematic Review And Meta-Analysis
Published 2024 - 42nd Congress of the ESCRS
Reference: FP22.02 | Type: Free paper | DOI: 10.82333/at93-dx04
Authors: Mohammad Karam 1 , Abdulmalik Alsaif* 2 , Abdulaziz Hassan 3 , Merwi Alhadeyah 4 , Ali Alkhabbaz 3 , Hamad Alawadhi 3 , Andre Pollmann 5 , Siddharth Nath 1 , Abdulrahman Alotaibi 1 , Mahshad Darvish 1 , Samir Jabbour 5
1McGill University,Montréal,Canada, 2KKESH,Riyadh,Saudi Arabia, 3Albahar eye center,Kuwait,Kuwait, 4AlBahar Eye Center,Kuwait,Kuwait, 5Centre Hospitalier de l'Université de Montréal,Montréal,Canada
Purpose
This systematic review and meta-analysis summarizes the evidence relating to the outcomes of Descemet membrane endothelial keratoplasty (DMEK) using eye bank pre-stripped versus surgeon prepared grafts.
Setting
Systematic Review and meta-analysis
Methods
This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PROSPERO ID: CRD42023457120). Searches of Medline (Ovid), EMBASE, EMCARE, the Cochrane Register of Controlled Trials, and grey literature were performed until October 2023. All comparative studies comparing DMEK outcomes after eye bank prepared (pre-stripped only) with surgeon-prepared tissue were included. Two independent reviewers completed data extraction and performed quality assessments. The co-primary outcomes were the rebubbling rate and corrected distance visual acuity (CDVA). Random effects modelling was used for the meta-analysis.
Results
Five studies with a total of 750 eyes receiving DMEK grafts were eligible for inclusion. These consisted of four retrospective observational studies and one non-randomized prospective study. There were no significant differences between eye bank pre-stripped and surgeon-prepared graft outcomes with regards to rebubbling rate (odds ratio, 1.11; 95% confidence interval [CI], 0.65 to 1.90) and postoperative logMAR CDVA (mean difference -0.11, 95% CI, -0.23 to 0.01). No statistically significant difference was noted in postoperative corneal thickness, endothelial cell loss or density and postoperative complications.
Conclusions
Observational data show that CDVA and rebubbling outcomes after DMEK are comparable between eye bank precut grafts and surgeon-prepared grafts.