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van Rooij J, Engel A, Steijger-Vermaat P, Molenaar A, Vigueras-Guillén JP, Wubbels RJ. Donor lamella thickness after ultrathin Descemet stripping automated endothelial keratoplasty and its relation to postoperative visual acuity and pre-operative lamella measures. BMC Ophthalmol 2023; 23:265. [PMID: 37308898 DOI: 10.1186/s12886-023-03019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/05/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND To accurately measure ultrathin Descemet stripping automated endothelial keratoplasty (DSAEK) donor lamella thickness during the first postoperative year and to correlate this with pre-operative and other postoperative measurements. METHODS Donor lamella thickness in 41 eyes undergoing DSAEK for Fuchs endothelial dystrophy (FED) was measured using the Tomey Casia OCT directly after graft preparation and at 1 week and 1, 3, 6 and 12 months postoperatively. Visual acuity and endothelial cell density were measured as the secondary parameters. RESULTS Individual graft thickness profiles were shown to be fairly regular within the optically relevant area. There was a strong and highly significant correlation between the pre- and postoperative lamellar thicknesses at all time points (p < 0.0001). Compared with the measurements directly after preparation at the cornea bank, the lamella thickness decreased by 12% after 12 months. Between 1 and 12 months postoperatively, the lamella thickness (mean ± SD) changed from 112 ± 27 μm to 101 ± 21 μm. Best spectacle-corrected visual acuity (BSCVA) changed from 0.46 ± 0.30 logMAR pre-operatively through 0.36 ± 0.33 at 1 month to 0.13 ± 0.16 at 1 year postoperatively. The endothelial cell counts were comparable to those reported in previous studies. CONCLUSIONS Thickness profiles of individual grafts were fairly regular within the optically relevant area. A strong relationship between pre- and postoperative graft thicknesses was detected, and ultrathin DSAEK grafts prepared using methods similar to that applied in this study are expected to show a deswelling of around 12% during the first postoperative year. No correlation was detected between graft thickness and BSCVA.
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Affiliation(s)
- Jeroen van Rooij
- Rotterdam Eye Hospital, Schiedamse Vest 180, Rotterdam, 3011 BH, The Netherlands
| | - Angela Engel
- Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, 3011 BH, The Netherlands
| | | | - Annemieke Molenaar
- Cornea Department, ETB-BISLIFE, Markt 58, Beverwijk, 1941 BM, The Netherlands
| | | | - René J Wubbels
- Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, 3011 BH, The Netherlands.
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Fenech MT, Coco G, Pagano L, Gadhvi KA, Titley M, Levis HJ, Parekh M, Kaye SB, Romano V. Thinning rate over 24 months in ultrathin DSAEK. Eye (Lond) 2023; 37:655-659. [PMID: 35292772 PMCID: PMC9998379 DOI: 10.1038/s41433-022-02011-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 02/14/2022] [Accepted: 02/24/2022] [Indexed: 11/08/2022] Open
Abstract
AIM To describe the changes in corneal graft thickness following ultrathin Descemet's Stripping Automated Endothelial Keratoplasty (UT-DSAEK) comparing pre- and postoperative values over a 24-month period. METHODS In this retrospective single-center case series, patients who received eye bank-prepared tissues for UT-DSAEK surgery were included. Preoperative and postoperative graft thickness measurements were determined in the eye bank and in clinic using anterior segment optical coherence tomography (AS-OCT) images. Graft thickness measurements and their percentage change between preoperative values and values at 1 day, 1 week and 1, 6, 12, 24 months were calculated. RESULTS In total, 47 eyes of 47 patients with a mean age of 69 ± 11 years (29 males) were included. Twnty-three patients had Fuchs' endothelial dystrophy (49%) and the remaining 24 had pseudophakic bullous keratopathy (51%). In total, 29/47 eyes underwent UT-DSAEK alone (62%) and 18/47 received combined cataract surgery as a triple procedure (38%). Preoperative donor graft thickness was 92 ± 28 μm. Compared to preoperative values, where graft thickness increased to 194 ± 101.3 μm at 1 day, 151.1 ± 71.4 μm at 1 week, and 108.4 ± 52.5 μm at 1 month. Graft thickness continued to gradually decrease over time until 6 months (91.7 ± 33.6 μm), and then plateaued at 12 months (83.9 ± 25.0 μm), showing minimal changes at 2 years (101.4 ± 37.5 μm). CONCLUSION Preoperative DSAEK graft thickness measurements as reported by the eye bank are a valid approximation of DSAEK graft thickness at 6 months after surgery and these measurements tend to stabilize over time up to 2 years after surgery.
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Affiliation(s)
- Matthew T Fenech
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK
| | - Giulia Coco
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luca Pagano
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK.
- Humanitas Clinical and Research Center, via Manzoni 56, 20089, Rozzano, MI, Italy.
| | - Kunal A Gadhvi
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK
| | - Mitchell Titley
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Hannah J Levis
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Mohit Parekh
- Institute of Ophthalmology, University College London, London, UK
| | - Stephen B Kaye
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Vito Romano
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Instituto Universitario, Universidad de Oviedo and Fundacion de Investigacion Oftalmologica, Oviedo, Spain
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