Comparison of Outcomes Between Pull Through Descemet Membrane Endothelial Keratoplasty and Ultrathin Descemet Stripping Automated Endothelial Keratoplasty in Eyes With Fuchs’ Dystrophy

Aim: The aim of this work is to compare between the ultrathin descemet stripping automated endothelial keratoplasty (UT-DSAEK) and the contact lens-assisted pull through (endothelium in) descemet membrane endothelial keratoplasty (DMEK) as a treatment for Fuchs’ endothelial dystrophy
Methods: All consecutive patients were operated on by the same surgeon (M.B.) at Villa Serena-Villa Igea Private Hospitals, Forli, Italy, from January 2016 through June 2017 were included in a prospective study
Results: Eighty-two eyes in the DMEK group, two hundreds and fifty five eyes in the UT-DSAEK group completed 1-year follow-up Mean BCVA in DMEK patients was 0.28±0.14 preoperatively and increased to 0.87±0.22 at 3 months and to 0.97±0.21 at 6 months and then increased to 0.99±0.15 at 1 year after surgery. Increase in BCVA compared to the UT-DSAEK groups was statistically significant at 1 month (p1<0.001, p2<0.001), 3 months (p1<0.001, p2<0.001), 6 months (p1<0.001, p2<0.001) and even at 1 year (0.001, p2<0.001).
Mean BCVA in UT-DSAEK< 100 μm patients was 0.29±0.14 preoperatively and increased to 0.87±0.21 at 1 year after surgery. Increase in BCVA at 3 months surgery was statistically significant (p=0.021) compared with the other UT-DSAEK group with grafts thicker then 100 μm indicating faster visual rehabilitation with thinner grafts but at 6 months and at 1 year there was no significant differences
Conclusions: visual recovery is significantly faster and better in the DMEK group
DSAEK, DMEK, Fuchs’ Dystrophy