Six-Year outcome of ultrathin femtosecond Laser-assisted descemet stripping automated endothelial keratoplasty

PurposeThe present study aims to evaluate the survival rate outcomes of The Femtosecond laser assisted Ultrathin Descemet Stripping Automated Endothelial Keratoplasty (FS-UT-DSAEK) over a 6-year period in addition to other outcome measures.Material and methodsA retrospective study of 100 eyes with endothelial decompensation from various causes was studied. The Femtosecond laser assisted technique was used to prepare donor tissue with a graft thickness of 100 μm. We evaluated the rate of graft loss, best corrected visual acuity (BCVA), graft survival rate, immunologic rejection rates and any intra or postoperative complications.ResultsThe mean age of the participants was 63.86 years, the sex distribution showed that 61.9% of the participants were females, and 38% were males. The highest proportion of cases (56.5%) was associated with PBK. Most of eyes underwent the DSAEK procedure alone, accounting for 86%. Kaplan-Meier graft survival probability at 1 and 6 years was 93.1% and 86.9%, respectively. Statistical analysis using t-tests revealed that all comparisons between the pre- and subsequent BCVA measurements were statistically significant. Primary graft failure was observed in 8% and the most common complication was graft detachment, which was observed in 10%.ConclusionUp to our knowledge, we reported the longest follow up of FS-UT-DSAEK in the literature. Our data showed an excellent survival rate and complication profile with no clear harmful effect on the endothelium from laser preparation. However, the visual outcomes in comparison to MK-UT-DSAEK still is questionable and needs to be addressed with randomized trials.