Ultrathin Descemet's Stripping Automated Endothelial Keratoplasty with the Microkeratome Double-Pass Technique

Busin, Massimo; Madi, Silvana; Santorum, Paolo; Scorcia, Vincenzo; Beltz, Jacqueline

doi:10.1016/j.ophtha.2012.11.030

Cited by 204 publications

(179 citation statements)

References 29 publications

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“…18 Busin's technique of ultrathin DSAEK has achieved visual outcomes comparable to DMEK, with greater proportions of patients achieving 20/20 BCVA than with older iterations of EK. 17 Busin reported 48.8% patients achieved BCVA 20/20 or better at 24 months after ultrathin DSAEK, excluding eyes with vision-limiting comorbidity. 17 Similarly, half of patients undergoing DMEK achieve BCVA 20/20 or better.…”

Section: Accepted Manuscriptmentioning

confidence: 98%

“…17 Busin reported 48.8% patients achieved BCVA 20/20 or better at 24 months after ultrathin DSAEK, excluding eyes with vision-limiting comorbidity. 17 Similarly, half of patients undergoing DMEK achieve BCVA 20/20 or better. 45,103 As a comparison, excluding patients with ocular comorbidity, 94.6% of patients undergoing cataract surgery with phacoemulsification achieve BCVA of 20/40 or better, and 52.3% achieve 20/20 BCVA.…”

Section: Accepted Manuscriptmentioning

confidence: 98%

“…8,141 Newer techniques with thinner grafts have produced less hyperopic shift, in the order of 0.75D. 18 Additionally, thin DSAEK and DMEK result in only slight changes in astigmatism, 17,45 unlike thicker DSEK / DSAEK that may induce up to 0.6D of cylinder. 18 Regardless, hyperopic shift and astigmatism are correctable with refraction and so should have minimal effect on BCVA.…”

Section: Hyperopic Shift and Regular Astigmatismmentioning

confidence: 99%

“…Large studies of EK by Massimo Busin and Gerrit Melles reported a mean patient age of 68 years. 17,107 Sicam et al have shown in normal eyes that spherical aberration increases with age. 118 Contrastingly, Oshika et al found no correlation between age and spherical aberration, but identified weak but significant correlation between age and coma-like aberration.…”

Section: Age and Aberrationsmentioning

confidence: 99%

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Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.

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Section: Accepted Manuscriptmentioning

confidence: 98%

Section: Accepted Manuscriptmentioning

confidence: 98%

Section: Hyperopic Shift and Regular Astigmatismmentioning

confidence: 99%

Section: Age and Aberrationsmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…13,14 All incisions, including the side entries, were sealed air-tight with interrupted 10-0 nylon stitches. Postoperatively, patients were given topical antibiotics and steroids tapered down in a regimen previously described by our group.…”

Section: The Analysis Of This Retrospectivementioning

confidence: 99%