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Corneal clarity after Descemet membrane endothelial keratoplasty versus Descemet stripping endothelial keratoplasty: Two‐year outcomes
Author(s) -
Lazaridis A.,
Giallouros E.,
Sekundo W.,
Kymionis G.,
Papaconstantinou D.,
Chatzistefanou K.,
Droutsas K.
Publication year - 2017
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.1755-3768.2017.0s036
Subject(s) - scheimpflug principle , medicine , ophthalmology , descemet membrane , visual acuity , corneal topography , cornea
Purpose To compare the course of Scheimpflug corneal densitometry ( CD ) after Descemet membrane endothelial keratoplasty ( DMEK ) versus Descemet stripping automated endothelial keratoplasty ( DSAEK ) versus age‐matched controls. Methods From two consecutive series of 130 DMEK and 49 DSAEK cases, 54 DMEK and 25 DSAEK cases without prior corneal surgery, complicated intraoperative or postoperative course or vision‐limiting ocular comorbidities were included in this study. Pseudophakic eyes of age‐matched subjects were recruited as controls (n=20). Scheimpflug CD of the optically relevant zones (0‐2 mm and 2‐6 mm), best‐corrected visual acuity ( BCVA ) endothelial cell density ( ECD ) and central corneal thickness ( CCT ) were evaluated preoperatively and at 3, 6, 12 and 24 months postoperatively. Results CD was significantly lower after DMEK at 3 and 6 months compared to DSAEK (P≤0.012). The two groups reached similar levels of CD at 12 and 24 months after surgery (P≥0.056). Compared to healthy pseudophakic controls, central CD at 24 months after DMEK did not differ significantly (P=0.152). Postoperative BCVA was significantly higher after DMEK for every examination time point compared to DSAEK (P<0.001). ECD was similar in both groups (P≥0.081). Conclusions The first 6 postoperative months CD was lower and BCVA higher after DMEK compared to DSAEK . Notably, although CD reached similar levels in the midterm after both DMEK and DSAEK , BCVA remained significantly better after DMEK . Two‐year CD after DMEK was similar to CD of healthy pseudophakic eyes indicating an excellent restoration of corneal clarity in the midterm.