Comparison Of Visual Outcomes Of Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) With Penetrating Keratoplasty (PKP)

1. Taiichiro Chikama¹
2. Yoichi Sato¹
3. Naoyuki Yamada¹
4. Ryoji Yanai¹
5. Naoyuki Morishige¹

¹Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Japan

Purpose: The purpose of this study was to compare the visual outcomes after Descemet's stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP).

Methods: Twenty-two eyes of 22 patients who underwent DSAEK and twenty-one eyes of 21 patients who underwent PKP for bullous keratopathy were evaluated about visual acuity, subjective astigmatism and corneal front curvature with corneal topography (TMS-4, TOMEY, Japan) retrospectively from medical records. Surface Asymmetry Index (SAI), Surface Regularity Index (SRI) and Irregular Astigmatism Index (IAI) obtained by TMS-4 were compared in the cases with DSAEK and PKP.

Results: Average best corrected visual acuity improved from 0.05 to 0.40, 0.48, and 0.58 at three, six and twelve months after DSAEK, and from 0.04 to 0.36, 0.41, and 0.44 at three, six and twelve months after PKP respectively. Average subjective astigmatism changed from 1.35D to 1.63D, 1.32D and 1.40D at three, six and twelve months after DSAEK and from 1.23D to 3.71, 3.39 and 2.93 at three, six and twelve months after PKP respectively. There were statistically significant at three and six months (P < 0.01). SAI, SRI and IAI improved respectively at three, six and twelve months after DSAEK. However, there were no significant improvement after PKP (P < 0.05).

Conclusions: In spite of significant improvement of corneal surface irregularity in eyes with DSAEK, post-operative corrected visual acuity had no difference between DSAEK and PKP. This result suggests that we have any other factors such as existence of graft-recipient interface opacity avoiding good visual acuity in DSAEK.