Torras-Sanvicens Josep, Blanco-Domínguez Irene, Sánchez-González José-María, Rachwani-Anil Rahul, Spencer Juan-Felipe, Sabater-Cruz Noelia, Peraza-Nieves Jorge, Rocha-de-Lossada Carlos
Anterior Segment Department, Institut Clinic d'Oftalmologia, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
Ophthalmology Department, University of Barcelona, 08007 Barcelona, Spain.
J Clin Med. 2021 Jan 22;10(3):419. doi: 10.3390/jcm10030419.
To analyze objective and subjective visual quality differences between descemet membrane endothelial keratoplasty (DMEK) and ultra-thin descemet stripping automated endothelial keratoplasty (UT-DSAEK) with a paired contralateral-eye design.
A cross-sectional, comparative, and observational case series study between DMEK and UT-DSAEK were presented. Visual acuity, refractive status and corneal quality assessment were compared between both endothelial keratoplasty techniques. The sample consisted of 20 eyes (10 patients) diagnosed with Fuchs endothelial corneal dystrophy. All measurements were performed preoperatively and at six months after surgery. Analyzed data included the measurement of objective scattering index, modulation transfer function, Strehl ratio, and optical quality assessment (OQAS) values. Contrast sensitivity, subjective patient satisfaction, visual acuity, tomography, pachymetry, endothelial cell count, and refraction status were also analyzed.
Objective and subjective visual quality variables had similar results among UT-DSAEK and DMEK procedures. Statistically significant differences favoring DMEK against UT-DSAEK were found in endothelial cell density (658.80 ± 139.33 and 1059.00 ± 421.84 cells/mm, respectively), pachymetry (621.20 ± 33.74 and 529.70 ± 30.00 µm, respectively), and follow-up (45.50 ± 24.76 and 15.50 ± 8.43 months, respectively).
UT-DSAEK and DMEK revealed no differences in terms of objective and subjective visual quality. However, DMEK showed a faster recovery during the follow-up, increased endothelial cell density, lower pachymetry, and a more anatomical posterior keratometry against UT-DSAEK in this case series paired-eye study.
采用配对对侧眼设计分析深板层内皮角膜移植术（DMEK）与超薄Descemet膜剥除自动内皮角膜移植术（UT-DSAEK）之间客观和主观视觉质量的差异。
呈现了一项DMEK与UT-DSAEK之间的横断面、比较性观察病例系列研究。比较了两种内皮角膜移植技术之间的视力、屈光状态和角膜质量评估。样本包括20只眼睛（10例患者），均诊断为Fuchs内皮角膜营养不良。所有测量均在术前和术后6个月进行。分析的数据包括客观散射指数、调制传递函数、斯特列尔比和光学质量评估（OQAS）值的测量。还分析了对比敏感度、患者主观满意度、视力、断层扫描、角膜厚度测量、内皮细胞计数和屈光状态。
UT-DSAEK和DMEK手术的客观和主观视觉质量变量结果相似。在内皮细胞密度（分别为658.80±139.33和1059.00±421.84个细胞/mm）、角膜厚度测量（分别为621.20±33.74和529.70±30.00µm）以及随访时间（分别为45.50±24.76和15.50±8.43个月）方面，发现DMEK相对于UT-DSAEK有统计学显著差异。
UT-DSAEK和DMEK在客观和主观视觉质量方面没有差异。然而，在本配对眼病例系列研究中，DMEK在随访期间恢复更快，内皮细胞密度增加，角膜厚度更低，并且相对于UT-DSAEK，后表面角膜曲率更符合解剖结构。
