randomized, prospective comparison of clinical outcomes and confocal findings of precut versus manually dissected grafts for descemet’s stripping endothelial keratoplasty

purpose : to compare the outcome of surgery and postoperative complications between using manually dissected cornea in descemet’s stripping with endothelial keratoplasty (dsek) and using eye bank automated precut cornea in descemet’s stripping with automated endothelial keratoplasty (dsaek) methods : forty eyes with indication of endothelial keratoplasty (ek) were included in this randomized prospective clinical trial. the eyes were randomly divided into two groups. donor cornea in one group was dissected with curved blade by the surgeon, while precut cornea from eye bank was used in other group. all surgeries were performed in one center by three surgeons, authors of the article. patients were followed for 3 months. results : baseline parameters and demographic features were not significantly different between the two groups. the most common indication of ek in both groups was pseudophakic bullous keratopathy (pbk) (60%). endothelial cell loss in dsek and dsaek were 51.59% and 50.70%, respectively after 3 months follow-up (p=0.947). best spectacle-corrected visual acuity (bscva) and intraocular pressure (iop) after surgery and postoperative complications were not significantly different in both groups. prevalence and intensity of interface opacity was significantly lower in dsaek group after surgery. bscva equal or more than 20/100 was detected in 85% and 75% individuals in dsaek and dsek groups, respectively. conclusion : in conclusion, three months postoperative outcomes of ek were similar in the two groups of precut dsaek and manually dissected dsek. smooth and uniform layer in precut dsaek leads to lower interface opacity in patients.    iranian journal of ophthalmology 201022(4):31-42 © 2010 by the iranian society of ophthalmology