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Endothelial Keratoplasty: Fellow Eyes Comparison of Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty

Guerra, Frederico P MD*; Anshu, Arundhati MD*; Price, Marianne O PhD*; Price, Francis W MD†

doi: 10.1097/ICO.0b013e31821ddd25
Clinical Science

Purpose: To evaluate patients' perspectives and outcomes of 2 different endothelial keratoplasty (EK) techniques performed in the fellow eyes of the same patients: Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).

Methods: In this fellow eye, comparative, retrospective case series, the records of 15 patients who underwent DSAEK in 1 eye and DMEK in the fellow eye and completed at least 1 year of follow-up after the second procedure were reviewed. Visual outcomes and endothelial cell density were assessed. Patient satisfaction was evaluated using a subjective questionnaire.

Results: At 12 months postoperatively, the mean best spectacle–corrected visual acuity (BSCVA) in the DMEK group was 0.07 logarithm of the minimum angle of resolution (20/24) and 0.20 logMAR (20/32) in the DSAEK group (P = 0.004). The majority of the patients (85%) perceived better visual quality in the DMEK eye. Furthermore, 62% preferred or would recommend DMEK to a friend or relative, whereas 15% preferred DSAEK and 23% reported no preference between the surgical procedures. The 1-year endothelial cell loss and the perceived discomfort level during the postoperative period were comparable for the 2 procedures.

Conclusions: The majority of the patients preferred or would recommend the DMEK procedure. Faster visual recovery and better final visual acuity were the main benefits of the DMEK technique.

Author Information

From the *Cornea Research Foundation of America; and †Price Vision Group, Indianapolis, IN.

Received for publication November 25, 2010; revision received January 25, 2011; accepted March 31, 2011.

Drs. M.O. Price and F.W. Price received travel grants from Moria, Antony, France.

The authors declare no other disclosures or conflicts of interest.

Reprints: Marianne O. Price, Cornea Research Foundation of America, 9002 North Meridian Street, Suite 212, Indianapolis, IN 46260 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.