Abstract
PURPOSE: To compare objective and subjective outcomes after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the fellow eye of the same patients.
STUDY DESIGN: Single-center, retrospective case series.
METHODS: Seventeen patients with bilateral Fuchs endothelial dystrophy who underwent DSAEK earlier in 1 eye, and later underwent DMEK in the contralateral eye, composed study population. A chart review was completed to obtain follow-up data for at least 6 months after each surgery. Outcome measures included best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD). Subjective questionnaires were used to assess patients' satisfaction.
RESULTS: Preoperative BSCVA (logMAR) was siMilar in bpth groups, 0.66 +/- 0.4 in DMEK and 0.59 +/- 0.4 in DSAEK (P =.6). The DMEK group showed better BSCVA than the DSAEK group at the 6-month time point (0.25 +/- 0.1 and 0.39 +/- 0.1, for DMEK and DSAEK, respectively, P =.02). Preoperative ECD (cells/mm(2)) was similar in both groups (2647 +/- 249 and 2768 +/- 404, P =.3) in DMEK and DSAEK, respectively. There was statistically significant difference found in ECD at 6 months (2227 +/- 565 for DMEK and 1780 +/- 433 for DSAEK, P =.049). Subjective level of average satisfaction after DMEK was 6 and after DSAEK was 4.87 +/- 1.19 (P =.002).
CONCLUSIONS: DMEK provided better visual outcome and lower endothelial cell loss than DSAEK and a higher level of patient satisfaction when assessed at 6 months after surgery. Our results comparing the 2 procedures in the same patients support the benefits of DMEK, and suggest the need for long-term studies observing this new surgical procedure. (C) 2015 by Elsevier Inc. All rights reserved.