International Ophthalmology

, Volume 35, Issue 4, pp 533–540 | Cite as

Corneal back surface radius after DSEK and DSAEK: a comparative single surgeon case control study

  • Jan D. Unterlauft
  • Katharina Elsässer
  • Wolfgang Haigis
  • Gerd Geerling
Original Paper
First Online:
Received:
Accepted:

Abstract

The purpose of this study was to analyse and compare the visual and refractive results after DSEK with manual donor dissection and DSAEK with microkeratome-assisted donor dissection in a retrospective unmasked case control study. DSEK was performed in 15 eyes of 15 patients (74.9 ± 7.9 years; 4♂, 11♀). DSAEK was performed in 15 eyes of 15 patients (76.5 ± 6.6 years; 4♂, 11♀) using the Carriazo-Pendular-microkeratome and Schwindt artificial anterior chamber. The best corrected visual acuity (BCVA), corneal geometry assessed using Scheimpflug photography (SP) and anterior segment optical coherence tomography (AS-OCT) was regularly measured in 15 matched pairs receiving DSEK or DSAEK. Mean BCVA improved from 1.1 ± 0.5 to 0.5 ± 0.2 logMAR (p = 0.001) after DSEK and from 1.0 ± 0.5 to 0.2 ± 0.2 logMAR (p = 0.001) in the DSAEK-group. After 6 months, BCVA was significantly better in the DSAEK-group. Corneal refractive power decreased from 36.9 ± 1.5 to 35.9 ± 1.3 D (p = 0.01) in the DSEK-group and from 37.7 ± 1.6 to 36.4 ± 1.6 D (p = 0.01) in the DSAEK-group. The corneal back surface radius changed from 6.05 ± 1.6 to 5.82 ± 0.45 in the DSEK (p = 0.03) and from 6.72 ± 0.96 to 5.39 ± 0.33 in the DSAEK-group (p = 0.01). Mean central corneal thickness (CCT) measured by SP decreased from 741 ± 105 to 605 ± 63 µm (p = 0.26) after DSEK and from 700 ± 98 to 607 ± 88 µm (p = 0.01) after DSAEK. At no point in time during follow-up, mean CCT was significantly different in both groups. The ratio between central and peripheral transplant thickness decreased slightly from 0.65 ± 0.16 to 0.59 ± 0.16 after DSEK (p = 0.57) and from 0.52 ± 0.08 to 0.43 ± 0.14 after DSAEK (p = 0.17). The ratio difference between DSEK and DSAEK-groups was not statistically significant. The use of a pendular microkeratome for DSAEK results in faster visual rehabilitation but does not decrease the surgically induced change of cornea-based hyperopisation which is due to posterior corneal curvature.

Keywords

Cornea Descemet stripping endothelial keratoplasty (DSEK) Descemet stripping automated endothelial keratoplasty (DSAEK) Posterior corneal radius 
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Notes

Financial Support

Schwindt eyetec solutions supplied the artificial anterior chamber used for DSAEK in this study.

Conflict of interest

No conflicting relationship exists for any author.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Jan D. Unterlauft
    • 1
    • 2
  • Katharina Elsässer
    • 1
  • Wolfgang Haigis
    • 1
  • Gerd Geerling
    • 1
    • 3
  1. 1.University Eye Hospital WuerzburgWuerzburgGermany
  2. 2.Department of Ophthalmology, University Eye Hospital LeipzigUniversity of LeipzigLeipzigGermany
  3. 3.University Eye Hospital DuesseldorfDuesseldorfGermany

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