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

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• 作者：Jan D. Unterlauft ; Katharina Els?sser ; Wolfgang Haigis…
• 关键词：Cornea ; Descemet stripping endothelial keratoplasty (DSEK) ; Descemet stripping automated endothelial keratoplasty (DSAEK) ; Posterior corneal radius
• 刊名：International Ophthalmology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：35
• 期：4
• 页码：533-540
• 全文大小：743 KB
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• 作者单位：Jan D. Unterlauft (1) (2)
  Katharina Els?sser (1)
  Wolfgang Haigis (1)
  Gerd Geerling (1) (3)
  
  1. University Eye Hospital Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
  2. Department of Ophthalmology, University Eye Hospital Leipzig, University of Leipzig, Liebigstrasse 10-4, 04103, Leipzig, Germany
  3. University Eye Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Ophthalmology
  
• 出版者：Springer Netherlands
• ISSN：1573-2630

文摘

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.