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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.

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:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.