title: Venting incisions in DSAEK: implications for astigmatism, aberrations, visual acuity, and graft detachment.
abstract: OBJECTIVE
  To evaluate the impact of venting incisions on the best corrected visual acuity (BCVA), astigmatism, aberrations, and risk of graft detachment in Descemet stripping automated keratoplasty (DSAEK).
  
  
  METHODS
  This was a retrospective, comparative, consecutive case series of DSAEK procedures performed with (n = 266) and without (n = 110) venting incisions. Patients were treated with DSAEK for Fuchs' endothelial dystrophy at Aarhus University Hospital between 2011 and 2013. Data included preoperative keratometry and postoperative BCVA, subjective astigmatism, and Pentacam® HR tomography with corneal front surface (CFS) aberrations at 1 to 2 years of follow-up. Numbers of triple procedures (concurrent cataract surgery) and post-operative graft detachments were also noted. The venting and non-venting groups were compared by the data-means. Unpaired t-tests and Mann-Whitney tests were used for normally and non-normally distributed data, respectively. Differences in graft detachments were analyzed with Fisher's exact and Chi square test.
  
  
  RESULTS
  There was no significant difference in any parameter, except the numbers of triple procedures. BCVA (logMAR) was 0.25 ± 0.18 in the venting group and 0.25 ± 0.19 in the non-venting group (p = 0.92), subjective astigmatism was -1.53 ± 0.99 diopters and -1.33 ± 0.78 diopters (p = 0.15), respectively. CFS astigmatism and higher order aberrations were statistically uniform. The relative risk (RR) of graft detachment was also uniform between the venting versus non-venting group (RR 0.72, p = 0.40), and between triple versus non-triple procedures (RR 0.71, p = 0.43). The preoperative corneal curvature had no impact on the risk of graft detachment (p = 0.74).
  
  
  CONCLUSIONS
  Venting incisions in DSAEK do not significantly alter BCVA, astigmatism, CFS aberrations or reduce the risk of graft detachment in triple or non-triple procedures.
authors.affiliation: Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 10th Building, 2nd floor, DK - 8000, Aarhus C, Denmark, m.hovlykke@dadlnet.dk.
authors.forename: Maria
authors.initials: M
authors.lastname: Hovlykke
authors.forename: Anders
authors.initials: A
authors.lastname: Ivarsen
authors.forename: Jesper
authors.initials: J
authors.lastname: Hjortdal
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000503:physiopathology*; D003315:Cornea / Q000601:surgery; D063171:Corneal Pachymetry; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006084:Graft Rejection / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D066027:Transplant Recipients; D014792:Visual Acuity / Q000502:physiology*