Microkeratome-assisted ultrathin Descemet's stripping automated endothelial keratoplasty: A randomized trial comparing single-pass versus double-pass technique.

Abstract:

Purpose:To compare the outcomes of two techniques, for preparation of microkeratome-assisted ultrathin grafts for Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods:The study involved 20 eyes of 20 patients with pseudophakic bullous keratopathy, randomized into two groups. Group 1 eyes underwent microkeratome-assisted DSAEK using the single-pass technique for lenticule preparation, whereas group 2 eyes underwent microkeratome-assisted DSAEK using the double-pass technique. Patients were followed up till 6 months, postoperatively. Best-corrected visual acuity (BCVA) at final follow-up was considered as the primary outcome measure, whereas graft thickness (GT) contrast sensitivity and endothelial cell loss were considered as the secondary outcome measures. A P value of <0.05 was considered as statistically significant. Results:Baseline characteristics of two groups were comparable. The mean central GT was comparable in both groups at 6 months follow-up [group 1: 98 ± 24.46 μm, group 2: 129 ± 31.46 μm (P = 0.18)]. Both groups fared equally in terms of BCVA (P = 0.33). Contrast sensitivity was significantly better in group 1 eyes (P = 0.045). A statistically significant negative correlation was found between postoperative BCVA and postoperative GT (R = -0.728, P = 0.016). The percentage endothelial cell loss was slightly higher in group 2 eyes, although not statistically significant. Two eyes in group 2 experienced complications during lenticule preparation. None of the eye experienced any complication in the postoperative period. Conclusion:Both techniques provided grafts with comparable thickness and endothelial cell loss and were associated with comparable BCVA, at final follow-up visit. The contrast sensitivity was, however, better in eyes receiving grafts prepared with the single-pass technique.

journal_name

Indian J Ophthalmol

authors

Sharma N,Hussain AY,Nagpal R,Rathi A,Maharana PK,Sinha R,Agarwal T,Titiyal JS

doi

10.4103/ijo.IJO_1660_18

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

1289-1294

issue

8

eissn

0301-4738

issn

1998-3689

pii

IndianJOphthalmol_2019_67_8_1289_263115

journal_volume

67

pub_type

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