Influence of donor lamella thickness on visual acuity after Descemet's stripping automated endothelial keratoplasty (DSAEK) [Einfluss der Spenderlamellendicke auf die Sehschärfe nach "Descemet's stripping automated endothelial keratoplasty" (DSAEK)]

Background: The aim of this study was to evaluate the effect of donor lamella thickness on postoperative visual acuity after Descemet's stripping automated endothelial keratoplasty (DSAEK). Materials and methods: A retrospective analysis of 65 eyes from 61 patients who underwent DSAEK surgery in cases of Fuchs' corneal dystrophy or bullous keratopathy between 2008 and 2011 was performed. The thickness of donor lamella was measured intraoperatively by ultrasonic pachymetry and postoperatively by anterior segment optical coherence tomography (OCT) and correlated to the visual acuity and number of endothelial cells. Results: The donor lamella thickness measured intraoperatively and postoperatively correlated significantly with each other (r = 0.874, p < 0.001). A significant correlation was found between postoperative corneal lamella thickness measured by anterior segment OCT and visual acuity (r = 0.273, p = 0.028) but not between intraoperative donor lamella thickness measured by ultrasonic pachymetry and visual acuity (r = 0.241, p = 0.103). The postoperative endothelial cell number did not show a correlation with either the intraoperatively or the postoperatively measured donor lamella thickness (r = - 0.059, p = 0.731, r = 0.024, p = 0.869, respectively). Conclusions: Corneal lamella thickness < 120 μm was found to be correlated with a better visual outcome than in cases of thicker corneas > 120 μm. Despite greater difficulty in corneal transplant technique in cases of thinner lamella no increased damage of corneal endothelium was shown. Therefore, DSAEK with corneal lamella thickness < 120 μm is an interesting therapeutic alternative to DMEK. © 2013 Springer-Verlag Berlin Heidelberg.