Retrospective Single-Center Registry Study on Graft Thickness 1 Year After Descemet Stripping Automated Endothelial Keratoplasty.

PURPOSE: To compare the graft thickness of eye bank precut grafts with graft thickness measured 1 year after Descemet stripping automated endothelial keratoplasty (DSAEK) and to correlate the graft thickness of eye bank precut grafts with best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD) 1 year after DSAEK.

METHODS: This was a retrospective registry study of 183 eyes of 179 DSAEK patients. Grafts were cut in the eye bank after 1 day in dextran-containing medium, and thickness was measured by optical coherence tomography immediately after precutting. Examinations 1 year after DSAEK included optical coherence tomography for graft thickness, BSCVA, and specular microscopy. Patients were divided into 2 groups based on the median graft thickness. The correlations between original graft thickness and graft thickness measured 1 year later, BSCVA, and ECD were analyzed by linear regression analyses.

RESULTS: Graft thickness decreased from 116 ± 36.8 μm before to 100 ± 36.8 μm 1 year after DSAEK (R =0.901, P <0.0001). Mean BSCVA 1 year after DSAEK was 0.24 logMAR in eyes without ocular comorbidity. BSCVA was 0.25 ± 0.16 (0.21-0.28) and 0.20 ± 0.11 (0.18-0.23) in eyes with a graft thickness above or below 111 μm, respectively (P = 0.04). ECD loss 1 year after surgery did not correlate with graft thickness (R = 0.0006, P <0.875).

CONCLUSIONS: Graft thickness measured immediately after precutting correlates strongly with graft thickness measured 1 year after DSAEK. This study suggests that ultrathin grafts provide better visual acuity 1 year after DSAEK than regular grafts.