title: Contralateral eye comparison of descemet membrane endothelial keratoplasty and descemet stripping automated endothelial keratoplasty.
abstract: OBJECTIVE
  To compare objective and subjective outcomes after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the fellow eye of the same patients.
  
  
  METHODS
  Single-center, retrospective case series.
  
  
  METHODS
  Seventeen patients with bilateral Fuchs endothelial dystrophy who underwent DSAEK earlier in 1 eye, and later underwent DMEK in the contralateral eye, composed study population. A chart review was completed to obtain follow-up data for at least 6 months after each surgery. Outcome measures included best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD). Subjective questionnaires were used to assess patients' satisfaction.
  
  
  RESULTS
  Preoperative BSCVA (logMAR) was similar in both groups, 0.66 ± 0.4 in DMEK and 0.59 ± 0.4 in DSAEK (P = .6). The DMEK group showed better BSCVA than the DSAEK group at the 6-month time point (0.25 ± 0.1 and 0.39 ± 0.1, for DMEK and DSAEK, respectively, P = .02). Preoperative ECD (cells/mm(2)) was similar in both groups (2647 ± 249 and 2768 ± 404, P = .3) in DMEK and DSAEK, respectively. There was statistically significant difference found in ECD at 6 months (2227 ± 565 for DMEK and 1780 ± 433 for DSAEK, P = .049). Subjective level of average satisfaction after DMEK was 6 and after DSAEK was 4.87 ± 1.19 (P = .002).
  
  
  CONCLUSIONS
  DMEK provided better visual outcome and lower endothelial cell loss than DSAEK and a higher level of patient satisfaction when assessed at 6 months after surgery. Our results comparing the 2 procedures in the same patients support the benefits of DMEK, and suggest the need for long-term studies observing this new surgical procedure.
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada. Electronic address: doctor.goldich@gmail.com.
authors.forename: Yakov
authors.initials: Y
authors.lastname: Goldich
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Showail
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Noa
authors.initials: N
authors.lastname: Avni-Zauberman
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Perez
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Randall
authors.initials: R
authors.lastname: Ulate
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Uri
authors.initials: U
authors.lastname: Elbaz
authors.affiliation: University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: David S
authors.initials: DS
authors.lastname: Rootman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology