Is ultra-thin Descemet stripping automated endothelial keratoplasty a viable alternative to Descemet membrane endothelial keratoplasty? A systematic review and meta-analysis.
Ther Adv Ophthalmol
; 15: 25158414221147823, 2023.
Article
en En
| MEDLINE
| ID: mdl-36776476
ABSTRACT
Background:
Ultra-thin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) is a recently developed surgical procedure that has shown promising results for the management of various corneal endothelial diseases.Objectives:
To evaluate the outcomes of the UT-DSAEK to the Descemet membrane endothelial keratoplasty (DMEK).Design:
A systematic analysis of the studies comparing UT-DSAEK with DMEK by evaluating one or more outcomes (vision, complications, and post-operative endothelial cell counts) was performed. The meta-analysis was done if two or more studies reported a common outcome.Methods:
We used PubMed, EMBASE, and SCOPUS databases to identify articles comparing the outcomes of UT-DSAEK with DMEK and performed a meta-analysis using RevMan, version 5.4.Results:
A total of six studies were included in this review (two randomized clinical trials and four non-randomized comparative studies). Our analysis showed the patients who underwent DMEK cases showed better visual outcomes with a mean difference of 0.06 LogMAR (95% CI 0.04-0.09) in BCVA, albeit with i 2 of 52% (heterogenous values). The evidence was weak, with the most weightage on retrospective studies. UT-DSAEK showed significantly fewer complications such as graft dislocations, with an odds ratio of 0.25 (95% CI 0.13-0.48). There was no significant difference in the endothelial cell counts with a mean difference of 86.34 (95%CI -133.09 to -305.77).Conclusion:
Although the literature is limited on UT-DSAEK with post-operative visual acuity that could be practically at par with DMEK, lesser complication rates and comparable post-operative endothelial cells could be a suitable alternative to DMEK for corneal endothelial pathologies.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Systematic_reviews
Idioma:
En
Revista:
Ther Adv Ophthalmol
Año:
2023
Tipo del documento:
Article
País de afiliación:
India