Comparison of Surgical Outcomes of Graft Survival Rate Using Surgeon Cut versus Precut DSAEK Tissue

To compare endothelial graft outcomes after DSAEK using pre-cut tissue and surgeon cut tissue in terms of final visual outcome and graft failure at 6 and 12 months postoperatively.

This retrospective study examined patients who underwent DSAEK with CB or surgeon-prepared tissue for any etiology of endothelial dysfunction. Best-corrected visual acuity (BCVA), corneal thickness, endothelial cell count (ECC), and complications were examined before and throughout the 1-year postoperative period.

Total number of cases is 98 eyes of 98 patients. Fifty-five surgeon-cut grafts were compared to 43 precut grafts. Preoperative visual acuity was >/= 20/60 in 1.8% and 0.0%, >20/60-20/200 in 21.8% and 7%, and less than 20/200 in 74.6% and 86.1% for surgeon cut and precut group respectively. Visual acuity at last follow-up was >/= 20/60 in 32.4% and 5.3%, >20/60-20/200 in 29.7% and 10.5%, and less than 20/200 in 37.8% and 84.2% for surgeon cut and precut group, respectively. At 6 months, 41 (83.7%) in the surgeon cut group and 27 (67.5%) in the precut groups completed the follow-up. Of these, 10 (24.4%) and 14 (32.6%) respectively, ended up with graft failure. The statistically significant difference in graft failure was maintained until 12 months: 37 (82.2%) in the surgeon cut group and 20 (58.8%) in the pre-cut group completed the follow-up. Of these, 11 (29.7%) and 14 (70%) labeled as failed grafts, respectively.

We found a higher rate of graft failure 6 to 12 months postoperatively in precut tissue grafts than in surgeon cut tissue grafts despite both tissues being provided by the same eye banks.