Ultra-Thin DSAEK Versus DMEK: Comparing Visual Results and Complications in Patients With 1 of Each

Tuesday, April 29, 2014: 9:01 AM
Room 152 (Boston Convention and Exhibition Center)
Mark A. Terry, MD, Devers Eye Institute, Portland, Oregon, USA
Cor van Zyl, FC Ophth (SA), Devers Eye Institute, Portland, OR, USA
Michael D. Straiko, MD, Devers Eye Institute, Portland, OR, USA
Peter B. Veldman, MD, Devers Eye Institute, Portland, OR, USA
Zachary M. Mayko, MS, Lions VisionGift, Portland, OR, USA

Narrative Responses:

Purpose
To report the comparative visual results and complications of patients that have an “ultra-thin” DSAEK in one eye and a DMEK graft in the other eye.

Methods
Sixteen patients received an ultra-thin DSAEK in one eye and subsequently received a DMEK in the other eye. Objective and subjective visual results were assessed at 6 or more months post-op, and complications recorded.

Results
Graft thickness for ultra-thin DSAEK eyes was 89 microns (range 71-106). One eye was re-bubbled for the DMEK group and none for DSAEK. There was no difference in mean preop vision for DSAEK eyes (20/50) and that of DMEK eyes (20/40) (p=0.20). The mean best post-op vision of ultrathin DSAEK (20/32) was statistically worse than vision after DMEK (20/25). (p=0.05) Post-op vision of 20/20 or better was present in 13% of “ultrathin” DSAEK eyes and 31% of DMEK eyes. 75% of patients preferred their DMEK eye to their DSAEK eye, and 2 out of 16 said the visions were equivalent.

Conclusion
DMEK surgery results in better visual results than even “ultra-thin” DSAEK surgery. Patients with a DMEK in one eye and a DSAEK in the other usually prefer the DMEK eye, but some patients will state the visual results are the same