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Venting incisions in DSAEK: implications for astigmatism, aberrations, visual acuity, and graft detachment

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Abstract

Purpose

To evaluate the impact of venting incisions on the best corrected visual acuity (BCVA), astigmatism, aberrations, and risk of graft detachment in Descemet stripping automated keratoplasty (DSAEK).

Methods

This was a retrospective, comparative, consecutive case series of DSAEK procedures performed with (n = 266) and without (n = 110) venting incisions. Patients were treated with DSAEK for Fuchs’ endothelial dystrophy at Aarhus University Hospital between 2011 and 2013. Data included preoperative keratometry and postoperative BCVA, subjective astigmatism, and Pentacam® HR tomography with corneal front surface (CFS) aberrations at 1 to 2 years of follow-up. Numbers of triple procedures (concurrent cataract surgery) and post-operative graft detachments were also noted.

The venting and non-venting groups were compared by the data-means. Unpaired t-tests and Mann–Whitney tests were used for normally and non-normally distributed data, respectively. Differences in graft detachments were analyzed with Fisher’s exact and Chi square test.

Results

There was no significant difference in any parameter, except the numbers of triple procedures. BCVA (logMAR) was 0.25 ± 0.18 in the venting group and 0.25 ± 0.19 in the non-venting group (p = 0.92), subjective astigmatism was −1.53 ± 0.99 diopters and −1.33 ± 0.78 diopters (p = 0.15), respectively. CFS astigmatism and higher order aberrations were statistically uniform. The relative risk (RR) of graft detachment was also uniform between the venting versus non-venting group (RR 0.72, p = 0.40), and between triple versus non-triple procedures (RR 0.71, p = 0.43). The preoperative corneal curvature had no impact on the risk of graft detachment (p = 0.74).

Conclusion

Venting incisions in DSAEK do not significantly alter BCVA, astigmatism, CFS aberrations or reduce the risk of graft detachment in triple or non-triple procedures.

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Acknowledgments

The Pentacam® HR was donated by the Bagenkop-Nielsen Myopia Foundation.

Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 10th Building, 2nd floor, DK - 8000, Aarhus C, Denmark

    Maria Hovlykke, Anders Ivarsen & Jesper Hjortdal

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  1. Maria Hovlykke
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  2. Anders Ivarsen
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  3. Jesper Hjortdal
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Correspondence to Maria Hovlykke.

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Hovlykke, M., Ivarsen, A. & Hjortdal, J. Venting incisions in DSAEK: implications for astigmatism, aberrations, visual acuity, and graft detachment. Graefes Arch Clin Exp Ophthalmol 253, 1419–1424 (2015). https://doi.org/10.1007/s00417-015-3101-4

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  • DOI: https://doi.org/10.1007/s00417-015-3101-4

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