Descemet stripping automated endothelial keratoplasty versus descemet membrane endothelial keratoplasty: a meta-analysis.
Int Ophthalmol
; 38(2): 897-905, 2018 Apr.
Article
en En
| MEDLINE
| ID: mdl-28417337
ABSTRACT
PURPOSE:
To evaluate the efficacy and safety of descemet stripping automated endothelial keratoplasty (DSAEK) compared with descemet membrane endothelial keratoplasty (DMEK).METHODS:
Databases including PubMed, EMBASE, and Cochrane Library were searched to find studies that compared DSAEK and DMEK outcomes. Efficacy parameters were the postoperative best-corrected visual acuity (BCVA) and spherical equivalent (SE). Safety parameters were postoperative endothelial cell loss (ECL), air injection (rebubbling), graft failure, graft rejection, and high intraocular pressure (IOP). Results from last visit were pooled for the analyses because the follow-up ranged from 3 to 24 months.RESULTS:
A total of 7 trials including 433 eyes were selected for this meta-analysis. BCVA was reported in all 7 studies, ECL% and rebubbling rate were reported in 6, and the remaining outcomes were reported in only 3 or 2 studies. Postoperative logMAR BCVA was significantly better for DMEK than that for DSAEK (P < 0.00001). More patients achieved the postoperative BCVA ≥ 20/25 and 20/20 in DMEK group than that in DSAEK (P > 0.001), whereas the proportion of patients whose postoperative BCVA ≥ 20/40 and the amount of SE did not differ statistically (P = 0.32 and P = 0.50, respectively). The DSAEK group has a significantly lower frequency of rebubbling than the DMEK group (P < 0.0001). The postoperative ECL%, graft failure, graft rejection, and high IOP were comparable between the 2 groups (all P values >0.05).CONCLUSIONS:
Our meta-analysis suggests that DMEK provided better visual outcomes with similar safety when compared to DSAEK. Given the limited sample size, further investigations are needed to validate these findings.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedades de la Córnea
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Lámina Limitante Posterior
/
Queratoplastia Endotelial de la Lámina Limitante Posterior
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Int Ophthalmol
Año:
2018
Tipo del documento:
Article
País de afiliación:
China