Comparative Evaluation of Use of 400-μm and 350-μm Microkeratome Head to Prepare Donor Tissue in Cases of Descemet Stripping Automated Endothelial Keratoplasty

    loading  Checking for direct PDF access through Ovid



To compare the outcomes of 400-μm microkeratome head with 350-μm microkeratome head Descemet stripping automated endothelial keratoplasty (DSAEK) in a prospective comparative study.


Twenty cases of pseudophakic bullous keratopathy were randomly allocated into two groups. Group 1 underwent slow, single-pass 400-μm microkeratome head, whereas group 2 underwent the standard technique of DSAEK using a 350-μm microkeratome head. The primary outcome measures were best-corrected visual acuity (BCVA) at 6 months.


Groups were comparable in baseline characteristics. The mean central graft thickness (GT) at 6 months in group 1 was significantly thinner than group 2 (90.44±28.67 vs. 165.60±62.74 μm; P=0.003). The BCVA and contrast sensitivity were significantly better in group 1 than in group 2 (BCVA: 0.34±0.15 vs. 0.53±0.19 logMAR units, P=0.02; contrast sensitivity: 1.48±0.13 vs. 1.06±0.22, P=0.001). A significant correlation was found between both postoperative BCVA and contrast sensitivity, with the postoperative GT using Spearman rho correlation analysis (R=0.534, P=0.01 for BCVA and R=−0.522, P=0.02 for contrast sensitivity). The percentage endothelial cell loss was comparable between the 2 groups at the last follow-up (P=0.3). No major complications were observed during the study period.


The use of a 400-μm microkeratome head instead of 350-μm head can improve the visual outcomes in DSAEK without increasing the risk of complications. The thickness of the DSAEK graft can affect the visual acuity and contrast sensitivity.

Related Topics

    loading  Loading Related Articles