Abstract:
BACKGROUND: Studies have shown that vision recovery with thinner grafts is faster and the risk of rejection is lower. In China, there is a lack of clinical efficacy analysis of different graft thicknesses after endothelial transplantation. Therefore, determining the optimal graft thickness is crucial for improving surgical efficacy.
OBJECTIVE: To evaluate the effects of different graft thickness on vision recovery and other prognostic indexes after simple Descemet’s stripping endothelial keratoplasty.
METHODS: A total of 72 patients (72 eyes) with corneal endothelial decompensation who received simple Descemet’s stripping endothelial keratoplasty at the General Hospital of Northern Theater Command from January 2013 to February 2023 were selected. There were 32 cases (32 eyes) in the thin graft group (< 100 μm) and 40 cases (40 eyes) in the thick graft group (≥ 100 μm). The best corrected visual acuity, corneal endothelial cell count, corneal graft transparency, postoperative complications and graft survival were observed in both groups before and 1, 3, 6, and 12 months after surgery.
RESULTS AND CONCLUSION: The visual acuity after surgery was significantly improved in both groups, and the best corrected visual acuity 3 months after surgery in the thin graft group was better than that in the thick graft group (P < 0.05). There was no significant difference in the number of corneal endothelial cells and graft transparency between the two groups 1 year after surgery (P > 0.05). There was no significant difference in the incidence of postoperative complications such as secondary glaucoma, graft immune rejection and graft displacement between the two groups (P > 0.05). There was no significant difference in the 1-year survival rate of grafts between the two groups (93.8% vs. 92.3%, P > 0.05). To conclude, simple Descemet’s stripping endothelial keratoplasty is a safe and effective surgical method for corneal endothelial transplantation, and its postoperative efficacy is similar to that of traditional Descemet’s stripping endothelial keratoplasty, and the graft implantation method is simpler. Thinner grafts can provide optimal corrected vision earlier and complete corneal remodeling sooner. Therefore, in the treatment of corneal endothelial decompensation, thinner grafts are preferred to improve recovery time.

Key words: Descemet’s stripping endothelial keratoplasty, corneal endothelial decompensation, secondary glaucoma, graft displacement, primary transplantation failure, graft rejection, corneal endothelial cell count, corneal transplantation