J Korean Ophthalmol Soc.  2013 Nov;54(11):1655-1662. 10.3341/jkos.2013.54.11.1655.

Comparing Clinical Outcomes of Descemet's Membrane Stripping Automated Endothelial Keratoplasty Between Graft Insertion Methods

• Baek JW
• Hwang KY
• Joo CK

• KMID: 2217910
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1655

Abstract

PURPOSE
To compare clinical outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) between different graft insertion methods.
METHODS
The clinical records of 32 eyes of 30 DSAEK patients were retrospectively analyzed. Patients were divided into 2 groups according to graft insertion method. Group A: Taco-folding, group B: Tan-endoglide. The best corrected visual acuities (BCVA), intraocular pressures, astigmatism, endothelial cell count, central corneal thickness and complications were evaluated pre and post-operatively.
RESULTS
The average follow-up period was 19 months (range 1-67). Postoperative log MAR visual acuity had significantly improved both from 1.63 (log MAR) to 0.69 and 0.53 at 12 months in each group (p = 0.035, p = 0.000). Mean endothelial cell survival of each group at 1 month postoperative were 75.8% (range 62.7-88.6) and 87.7% (range 70.2-97.9), respectively (p = 0.012). The differences of BCVA improvement and endothelial cell survival between the groups at 12 months were not significant (p = 0.393, p = 0.544).
CONCLUSIONS
Both methods showed fast visual recovery. Using Tan-endoglide insertion resulted less endothelial cell loss at early post-operative period and showed less post-operative complication and graft failure.

Keyword

DSAEK; Tan-endoglide; Taco-folding; Keratopkasty

MeSH Terms

Astigmatism
Corneal Transplantation*
Descemet Membrane*
Endothelial Cells
Follow-Up Studies
Humans
Intraocular Pressure
Methods*
Retrospective Studies
Transplants*
Visual Acuity

Figure

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  Figure 1. Post-operative visual acuity and astigmatism changes of of Descemet's stripping automated endothelial keratoplasty (DSAEK) patients by insertion method. *Mann-Whitney U test between Taco-folding group and Tan-endoglide group.

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  Figure 2. Central corneal thickness of Descemet's stripping automated endothelial keratoplasty (DSAEK) patients by donor insertion method. *Mann-Whitney U test between Taco-folding group and Tan-endoglide group.

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  Figure 3. Mean endothelial cell density and endothelial cell survival of Descemet's stripping automated endothelial keratoplasty (DSAEK) patients by insertion method. *Mann-Whitney U test between Taco-folding group and Tan-endoglide group.

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  Figure 4. Early post-operative intraocular pressure changes of of Descemet's stripping automated endothelial keratoplasty (DSAEK) patients by insertion method. *Mann-Whitney U test between Taco-folding group and Tan-endoglide group.

Reference

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