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Graft thickness and visual acuity after automated endothelial keratoplasty
Author(s) -
RABOT A,
SOLER V,
FOURNIE P
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.t100.x
Subject(s) - microkeratome , medicine , ophthalmology , visual acuity , significant difference , surgery , keratomileusis
Purpose Endothelial keratoplasty has become the standard of care for endothelial disease. Descemet Membrane Endothelial Keratoplasty (DMEK) gives superior visual results but poses several surgical challenges, compared to Descemet Stripping Automated Endothelial Keratoplasty (DSAEK). Graft thickness was advanced as a reason for this difference. Ultrathin‐DSAEK, with a double microkeratome pass has been proposed to maintain the advantages of both DSAEK and DMEK. The purpose of this study was to evaluate the possible correlation between visual acuity (VA) and central graft thickness in DSAEK. Methods A preliminary retrospective study was conducted on 42 patients who underwent DSAEK: 26 operated on with a single microkeratome pass with a 350 microns (µm) head, and 16 with a double pass using a 200 µm head. Pre‐ and post‐operative VA, and post‐operative central corneal graft thickness measured by OCT and Scheimpflug imaging were collected with at least 6 months follow‐up. Results The overall mean of graft thickness was 127.25 ± 40µm. The overall mean VA was 0.16logMAR. 38% of patients had at least 0.1logMAR VA. Graft thickness was 136.8 ± 43.4µm with a single microkeratome pass compared to 111 ± 30µm with a double pass (p<0.05). Considering the overall cohort, we had a correlation between graft thickness and VA (p<0.05), but also between the pre and post‐operative VA (p<0.05). We had no correlation between graft thickness and VA in the double pass subgroup. No difference was found between the single and the double pass subgroups for VA. Conclusion There is no clear correlation between graft thickness and visual acuity. Other factors may come into account such as scarring of the interface, or the stage of endothelial failure.Preoperative VA could be a prognosis factor.