In Fuchs endothelial dystrophy (FED), the corneal endothelial layer undergoes progressive degenerative changes leading to a reduction in endothelial cell count and subsequent visual impairment. Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) are two established surgical approaches for the management of FED. This meta-analysis aims to compare postoperative clinical outcomes between DMEK and UT-DSAEK in adult patients with FED. A literature search was conducted in major peer-reviewed electronic databases. Best-corrected visual acuity (BCVA) served as the primary outcome, while endothelial cell density (ECD) and postoperative complications were evaluated as secondary outcomes. Compared with UT-DSAEK, DMEK demonstrated a tendency toward better BCVA at one year, although it was also associated with a higher likelihood of requiring re-bubbling. No clear differences were observed between the two techniques regarding ECD at 12 months, while complication rates varied between studies. Overall, DMEK showed more favorable visual outcomes, whereas UT-DSAEK presented a lower complication burden. Although complications following DMEK are generally manageable, some may necessitate additional surgical procedures. Both techniques remain effective options for corneal surgeons treating patients with FED.
Katerini et al. (Wed,) studied this question.
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