title: Effect of cornea donor graft thickness on the outcome of Descemet stripping automated endothelial keratoplasty surgery.
abstract: OBJECTIVE
  To determine whether Descemet stripping automated endothelial keratoplasty (DSAEK) donor cornea graft thickness impacts measurements of best spectacle-corrected visual acuity (BSCVA), refractive error and intraocular pressure (IOP).
  
  
  METHODS
  Retrospective chart review in a tertiary care center at Duke University Eye Center.
  
  
  METHODS
  We studied 460 eyes that had undergone DSAEK surgery. They were segregated into three groups based on the thickness of the donor graft: <100 μm (n = 67 eyes); 100-150 μm (n = 316 eyes); and >150 μm (n = 77 eyes). The three graft-thickness groups were assessed at about 6 months postoperatively for measurement of BSCVA, spherical equivalent, and IOP.
  
  
  RESULTS
  Baseline demographics were similar in the three groups. All groups experienced significant improvement in BSCVA (mean ± SD = -0.34 ± 0.50 logMAR); mild hyperopic shift (mean ± SD = 0.48 ± 1.7 D); and stability in IOP measurements (mean ± SD = 0.19 ± 4.8 mm Hg). There were no significant differences in groups according to donor graft thicknesses with respect to change in BSCVA (P = 0.8); hyperopic shift (P = 0.76); or IOP measurement (P = 0.56).
  
  
  CONCLUSIONS
  DSAEK significantly improves BSCVA. DSAEK graft thickness may not play an important role in the final BSCVA, refractive error, or accuracy of IOP measurement. The ideal DSAEK graft thickness to minimize graft-related complications remains to be determined.
authors.affiliation: Duke University Eye Center, Duke University, Durham, North Carolina.
authors.forename: Yassine J
authors.initials: YJ
authors.lastname: Daoud
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Munro
authors.forename: Derek D
authors.initials: DD
authors.lastname: Delmonte
authors.forename: Sandra
authors.initials: S
authors.lastname: Stinnett
authors.forename: Terry
authors.initials: T
authors.lastname: Kim
authors.forename: Alan N
authors.initials: AN
authors.lastname: Carlson
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Afshari
mesh_terms: D000368:Aged; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D009929:Organ Size; D012030:Refractive Errors / Q000503:physiopathology*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*