Corneal back surface radius after DSEK and DSAEK: a comparative single surgeon case control study

Area of Science:

• Ophthalmology
• Corneal Surgery
• Visual Optics

Background:

• Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) are advanced surgical techniques for endothelial dysfunction.
• Manual donor dissection in DSEK and microkeratome-assisted dissection in DSAEK represent different approaches to tissue preparation.
• Comparing visual and refractive outcomes is crucial for optimizing surgical strategies in endothelial keratoplasty.

Purpose of the Study:

• To compare the visual and refractive outcomes of DSEK with manual donor dissection versus DSAEK with microkeratome-assisted donor dissection.
• To evaluate the impact of different donor dissection methods on visual acuity, corneal geometry, and central corneal thickness.

Main Methods:

• A retrospective, unmasked case-control study involving 15 eyes undergoing DSEK and 15 eyes undergoing DSAEK.
• Best corrected visual acuity (BCVA), corneal geometry (Scheimpflug photography, AS-OCT), and central corneal thickness (CCT) were measured.
• Patients in both groups had similar baseline characteristics and were matched for comparison.

Main Results:

• Both DSEK and DSAEK groups showed significant improvement in BCVA (p=0.001).
• DSAEK group achieved significantly better BCVA at 6 months compared to the DSEK group.
• Corneal refractive power and posterior corneal curvature changed significantly in both groups, with DSAEK showing a more pronounced change in posterior curvature.

Conclusions:

• Microkeratome-assisted DSAEK leads to faster visual rehabilitation and superior visual acuity compared to manual DSEK.
• While both techniques alter corneal refractive power and curvature, DSAEK's use of a microkeratome influences posterior corneal curvature more significantly.
• DSAEK is a preferred method for achieving faster visual recovery in endothelial keratoplasty.