Descemet Membrane Endothelial Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty

center dot PURPOSE: To evaluate visual outcome and endothelial cell survival after Descemet membrane endothelial keratoplasty (DMEK) in comparison with Descemet stripping automated endothelial keratoplasty (DSAEK). center dot DESIGN: Single-center, retrospective, consecutive case series. center dot METHODS: Thirty-eight eyes of 38 consecutive patients undergoing DMEK, who completed a 6-month follow-up, were compared with 35 eyes of 35 consecutive patients undergoing DSAEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy. Main outcome measures included best-corrected visual acuity (in logarithm of the minimal angle of resolution [logMAR] units) and endothelial cell density within a 6-month follow-up. center dot RESULTS: Best-corrected visual acuity increased from 0.70 +/- 0.48 logMAR and 0.75 +/- 0.32 logMAR before surgery to 0.21 +/- 0.14 logMAR and 0.48 +/- 0.19 logMAR 3 months after DMEK and DSAEK (P < .001), respectively, and to 0.17 +/- 0.12 logMAR and 0.36 +/- 0.15 logMAR 6 months after DMEK and DSAEK (P < .001), respectively. Endothelial cell density decreased from 2575 +/- 260 cells/mm(2) and 2502 +/- 220 cells/mm(2) before surgery to 1498 +/- 244 cells/mm(2) and 1778 +/- 420 cells/mm(2) 3 months after DMEK and DSAEK (P < .001), respectively, and to 1520 +/- 299 cells/mm(2) and 1532 +/- 495 cells/mm(2) 6 months after DMEK and DSAEK (P = .483), respectively. Central corneal thickness decreased from 652 +/- 92 mu m before surgery to 517 +/- 45 mu m 6 months after DMEK, and from 698 +/- 137 mu m before surgery to 618 +/- 66 mu m 6 months after DSAEK. center dot CONCLUSIONS: DMEK provided faster and more complete visual rehabilitation when compared with DSAEK. However, there were no significant differences concerning endothelial cell survival within a 6-month follow-up. (Am J Ophthalmol 2012;153:1082-1090. (C) 2012 by Elsevier Inc. All rights reserved.)