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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-08-2013 | Cornea

Visual outcome and histological findings following femtosecond laser-assisted versus microkeratome-assisted DSAEK

Authors: S. Heinzelmann, P. Maier, D. Böhringer, C. Auw-Hädrich, T. Reinhard

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2013

Abstract

Background

The aim of this study was to compare the visual outcome of femtosecond laser-assisted Descemet stripping automated endothelial keratoplasty (DSAEK) to microkeratome-assisted DSAEK as well as to contrast precut versus surgeon-cut grafts. Histologic characterization of failed DSAEK grafts was performed in order to correlate ultrastructural changes with graft failures.

Methods

In this case control study, 47 cases of DSAEK were investigated in terms of visual acuity, keratometric astigmatism, spherical equivalent, endothelial cell count, and postoperative complications. We formed three groups: the femtosecondlaser-assisted DSAEK with precut grafts, the microkeratome-assisted DSAEK with precut and with surgeon-cut grafts. Mean follow-up was 6 months. In the case of graft failure, penetrating keratoplasty was performed, and the excised corneal buttons were investigated by light and electron microscopy.

Results

Microkeratome-assisted DSAEK lead to better visual outcome than femtosecond laser-assisted DSAEK. Keratometric astigmatism, spherical equivalent and endothelial cell count did not differ significantly between both methods. Precut and surgeon-cut grafts in microkeratome-assisted DSAEK did not show any significant difference regarding all upraised parameters. No definite histological correlate for graft failure following femtosecond laser-assisted DSAEK was found.

Conclusions

Femtosecond laser-assisted DSAEK is not the method of choice, and needs further technical improvement. However, failed femtosecondlaser-assisted DSAEK grafts did not show significant histological changes related to the technique to explain reduced visual acuity. In microkeratome-assisted DSAEK, the preparation time point of the graft does not seem to influence the visual and optical outcome.

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Title: Visual outcome and histological findings following femtosecond laser-assisted versus microkeratome-assisted DSAEK
Authors: S. Heinzelmann
P. Maier
D. Böhringer
C. Auw-Hädrich
T. Reinhard
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2013
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-013-2359-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Visual outcome and histological findings following femtosecond laser-assisted versus microkeratome-assisted DSAEK

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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