Macular Thickness After Ultrathin Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty Combined With Cataract Surgery: A Randomized Controlled Clinical Trial

Abstract

Purpose: The aim was to investigate alterations in central retinal thickness (CRT) and their implications for visual acuity after ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) combined with cataract surgery. Methods: A total of 72 eyes of 72 patients with Fuchs endothelial dystrophy and cataract were included and equally randomized to either UT-DSAEK or DMEK. A control group of 40 eyes of 40 patients with cataract were included for cataract surgery. All participants were examined preoperatively as well as 3 and 6 months postoperatively. Results: There was no significant difference in CRT between the study groups after surgery (P = 0.896). A significant difference in best-corrected visual acuity (BCVA) progression over time was found between the study groups (P < 0.0001). Average improvements of 8.03 EDTRS after UT-DSAEK (P < 0.001) and 16.77 EDTRS after DMEK (P < 0.001) were found 6 months postoperatively. No significant correlation was found between the change in BCVA and CRT from baseline to 3 months postoperatively (r2 < 0.0001, P = 0.96) and from baseline to 6 months postoperatively (r2 = 0.0053, P = 0.46). Conclusions: CRT was not altered by UT-DSAEK, DMEK, or cataract surgery 3 and 6 months postoperatively. BCVA significantly improved 3 and 6 months after UT-DSAEK and DMEK, respectively. No significant correlations were found between the change in BCVA and CRT postoperatively. As such CRT alterations were comparable after UT-DSAEK, DMEK, and cataract surgery.