title: Comparative Evaluation of Use of 400-μm and 350-μm Microkeratome Head to Prepare Donor Tissue in Cases of Descemet Stripping Automated Endothelial Keratoplasty.
abstract: OBJECTIVE
  To compare the outcomes of 400-μm microkeratome head with 350-μm microkeratome head Descemet stripping automated endothelial keratoplasty (DSAEK) in a prospective comparative study.
  
  
  METHODS
  Twenty cases of pseudophakic bullous keratopathy were randomly allocated into two groups. Group 1 underwent slow, single-pass 400-μm microkeratome head, whereas group 2 underwent the standard technique of DSAEK using a 350-μm microkeratome head. The primary outcome measures were best-corrected visual acuity (BCVA) at 6 months.
  
  
  RESULTS
  Groups were comparable in baseline characteristics. The mean central graft thickness (GT) at 6 months in group 1 was significantly thinner than group 2 (90.44±28.67 vs. 165.60±62.74 μm; P=0.003). The BCVA and contrast sensitivity were significantly better in group 1 than in group 2 (BCVA: 0.34±0.15 vs. 0.53±0.19 logMAR units, P=0.02; contrast sensitivity: 1.48±0.13 vs. 1.06±0.22, P=0.001). A significant correlation was found between both postoperative BCVA and contrast sensitivity, with the postoperative GT using Spearman rho correlation analysis (R=0.534, P=0.01 for BCVA and R=-0.522, P=0.02 for contrast sensitivity). The percentage endothelial cell loss was comparable between the 2 groups at the last follow-up (P=0.3). No major complications were observed during the study period.
  
  
  CONCLUSIONS
  The use of a 400-μm microkeratome head instead of 350-μm head can improve the visual outcomes in DSAEK without increasing the risk of complications. The thickness of the DSAEK graft can affect the visual acuity and contrast sensitivity.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences (S.J., N.S., T.A., R.S.), All India Institute of Medical Sciences, New Delhi, India; Department of Ophthalmology (P.K.M.), All India Institute of Medical Sciences, Bhopal, India; and Department of Ophthalmology (R.B.V.), Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Melbourne, Australia.
authors.forename: Srheyans
authors.initials: S
authors.lastname: Jain
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Prafulla K
authors.initials: PK
authors.lastname: Maharana
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sinha
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D055954:Corneal Endothelial Cell Loss; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology