Visual acuity outcomes after Descmet’s stripping automated endothelial keratoplasty compared to penetrating keratoplasty

Abstract

Purpose To evaluate the difference in visual recovery between Descmet’s Stripping Automated Endothelial Keratoplasty (DSAEK) and Penetrating Keratoplasty (PK). Methods Retrospective cohort study of 42 eyes. 21 eyes underwent PK compared to 21 eyes underwent DSAEK for a Fuchs’ dystrophy or pseudophakic bullous keratopathy. Preoperative and postoperative best spectacle‐corrected visual acuity (BSCVA) was recorded at 1, 3, 6 and 12 month. The PK and DSAEK procedures were performed by the same experienced surgeon with the same donor and similar recipient criteria. All patients underwent a standardized examination that included tonometry, visual acuity (distance and near) and biomicroscopic examination at 1 month, 3 month, 6 month and 12 month. Improvement in BSCVA between each point time was evaluated using paired‐samples t tests. Results The donor and recepient demographics were comparable in the PK and DSAEK groups. In the PK group, the visual recovery was significant after 12 month (1,71 logMAR +/‐ 0,33 to 1,25 logMAR +/‐ 0,58; P=0,023). The mean distance gain was 4,53 lines and the mean near gain was 3,89 lines. In the DSAEK group, the visual recovery was significant after 3 month (1,05 logMAR +/‐ 0,50 to 0,68 logMAR +/‐ 0,38; P=0,025). The mean distance gain was 4,25 lines and the mean near gain was 5,7 lines. The mean distance gain was equivalent between the two groups (P=0,91), and the mean near gain was statistically superior in the DSAEK group (P=0,47). Conclusion There is a faster visual recovery and a more significant near gain after DSAEK surgery for Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy.