DSAEK continues to serve a purpose in corneal transplantation
Many complex cases are better suited to UT-DSAEK
Dermot McGrath
Published: Saturday, September 14, 2019
Massimo Busin[/caption]
ALTHOUGH corneal transplantation surgery has seen an increase in Descemet Membrane Endothelial Keratoplasty (DMEK) in recent years for the reported benefits of quicker healing and better visual outcomes, procedures such as ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK) still have a valuable role to play for certain indications, according to Massimo Busin MD.
“DMEK is certainly a viable option for indications such as Fuchs’ endothelial dystrophy and gives excellent results, but there are still many complex cases, with poor visibility and certain comorbidities for instance, that are better suited to UT-DSAEK,” he told delegates attending the 10th EuCornea Congress in Paris.
Issues to bear in mind when considering UT-DSAEK versus DMEK is the preoperative eye status, surgical technique, outcomes and complications, noted Dr Busin. In his view, both procedures have a role to play depending on the needs of each individual patient.
DMEK is a good option, for instance in patients with Fuchs’ endothelial dystrophy, intact posterior capsule and normal anterior segment anatomy. However, UT-DSAEK is better adapted to cases with a shallow or poorly visualised anterior chamber or more complex eyes with ocular comorbidities such as glaucoma or severe pseudophakic bullous keratopathy, and aphakic or vitrectomised eyes.