Monitoring Postoperative Graft Thinning In Ut-Dsaek Using As-Oct: Clinical Relevance And Outcomes"

Ultra-thin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) is a widely used technique for treating endothelial dysfunction, offering faster visual recovery and improved outcomes compared to traditional endothelial keratoplasty methods. However, postoperative changes in graft thickness can influence visual acuity and overall graft survival. Anterior segment optical coherence tomography (AS-OCT) provides a precise, non-invasive method to monitor these temporal changes. This study aims to analyze the progression of central graft thinning following UT-DSAEK and evaluate its clinical significance.

Academic tertiary center eye institute

This retrospective cohort study included consecutive patients who underwent UT-DSAEK with Eusol-C - preserved corneas between 2023 and 2024 and had postoperative AS-OCT records. Data were collected on ultrasound central corneal pachymetry when the cornea was mounted on an artificial chamber with the epithelium removed (CCT-1) and after the microkeratome cut (CCT-2). The microkeratome was set to remove a predetermined thickness of 300–400 μm. Postoperatively, central graft thickness was measured using AS-OCT at 1 day, 1 month, and 3 months after surgery.

Seven patients (4 males, 3 females; mean age 70.7 ± 10.3 years) met the inclusion criteria. Preoperative best-corrected visual acuity (BCVA) was LogMAR 1.63 ± 0.69. The mean CCT-1 was 552 ± 40.5 μm, and CCT-2 was 194.9 ± 38.3 μm. Postoperative graft thickness decreased from 374 ± 206.7 μm on day 1 to 308 ± 204.9 μm at month 1 and 276.5 ± 201.3 μm at month 3. The mean thinning rate was 66.0 ± 22.7 μm by month 1 and 83.3 ± 34.5 μm by month 3.

Progressive postoperative thinning was observed in UT-DSAEK grafts preserved in Eusol-C. Moreover, by 3 months, the targeted graft thickness was achieved, showing a trend comparable to organ-culture methods. These findings support Eusol-C as a viable preservation medium for ultra-thin grafts. Further comparative studies are needed to assess long-term clinical outcomes and endothelial survival across different preservation techniques,