Early Graft Attachment And 12-Month Outcomes Of Imported Preloaded Vs. Surgeon-Cut Descemet's Stripping Automated Endothelial Keratoplasty
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR266 | Type: Free paper | DOI: 10.82333/86c4-yb35
Authors: Dr Halah Bin Helayel* 1 , Dr Rafah Fairaq 1 , Dr Mohammed Almutlak 2 , Dr Saeed Al-AMoudi 2 , Dr Mohammad A Ahad 2
1Anterior Segment Division ,king Khaled Eye Specialist Hospital ,Riyadh,Saudi Arabia, 2Anterior Segment Division ,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia
Purpose
To compare early graft attachment and graft survival between preloaded and surgeon-cut Descemet stripping automated endothelial keratoplasty (DSAEK) using imported donor tissue
Setting
Tertiary referral ophthamic center.
Methods
Retrospective comparative study of 131 DSAEK procedures performed between 2021 and 2025 using either preloaded (n=78) or surgeon-cut (n=53) grafts. Visual acuity, graft detachment, rebubbling, donor and graft characteristics, and graft failure were analyzed.
Results
Early graft detachment occurred exclusively in surgeon-cut grafts (13.2%) and not in any preloaded grafts (P=0.001). Surgeon-cut grafts were significantly thicker and had longer storage times (both P<0.001). Preloaded grafts demonstrated faster early visual recovery, though long-term visual outcomes at 12 months were similar. At 12 months, graft survival did not differ significantly between techniques. Early graft detachment was the dominant determinant of poor visual outcome and subsequent graft failure.
Conclusions
In an import-dependent setting, preloaded and surgeon-cut DSAEK yield comparable long-term outcomes when evaluated at fixed time points. The graft preparation technique impacted early postoperative attachment but was not associated with long-term graft failure.