title: Corneal back surface radius after DSEK and DSAEK: a comparative single surgeon case control study.
abstract: The purpose of this study was to analyse and compare the visual and refractive results after DSEK with manual donor dissection and DSAEK with microkeratome-assisted donor dissection in a retrospective unmasked case control study. DSEK was performed in 15 eyes of 15 patients (74.9 ± 7.9 years; 4♂, 11♀). DSAEK was performed in 15 eyes of 15 patients (76.5 ± 6.6 years; 4♂, 11♀) using the Carriazo-Pendular-microkeratome and Schwindt artificial anterior chamber. The best corrected visual acuity (BCVA), corneal geometry assessed using Scheimpflug photography (SP) and anterior segment optical coherence tomography (AS-OCT) was regularly measured in 15 matched pairs receiving DSEK or DSAEK. Mean BCVA improved from 1.1 ± 0.5 to 0.5 ± 0.2 logMAR (p = 0.001) after DSEK and from 1.0 ± 0.5 to 0.2 ± 0.2 logMAR (p = 0.001) in the DSAEK-group. After 6 months, BCVA was significantly better in the DSAEK-group. Corneal refractive power decreased from 36.9 ± 1.5 to 35.9 ± 1.3 D (p = 0.01) in the DSEK-group and from 37.7 ± 1.6 to 36.4 ± 1.6 D (p = 0.01) in the DSAEK-group. The corneal back surface radius changed from 6.05 ± 1.6 to 5.82 ± 0.45 in the DSEK (p = 0.03) and from 6.72 ± 0.96 to 5.39 ± 0.33 in the DSAEK-group (p = 0.01). Mean central corneal thickness (CCT) measured by SP decreased from 741 ± 105 to 605 ± 63 µm (p = 0.26) after DSEK and from 700 ± 98 to 607 ± 88 µm (p = 0.01) after DSAEK. At no point in time during follow-up, mean CCT was significantly different in both groups. The ratio between central and peripheral transplant thickness decreased slightly from 0.65 ± 0.16 to 0.59 ± 0.16 after DSEK (p = 0.57) and from 0.52 ± 0.08 to 0.43 ± 0.14 after DSAEK (p = 0.17). The ratio difference between DSEK and DSAEK-groups was not statistically significant. The use of a pendular microkeratome for DSAEK results in faster visual rehabilitation but does not decrease the surgically induced change of cornea-based hyperopisation which is due to posterior corneal curvature.
authors: University Eye Hospital Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany, Jandarius.Unterlauft@medizin.uni-leipzig.de.
authors: Jan D
authors: JD
authors: Unterlauft
authors: Katharina
authors: K
authors: Elsässer
authors: Wolfgang
authors: W
authors: Haigis
authors: Gerd
authors: G
authors: Geerling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003886:Descemet Membrane / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology