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DMEK versus DSAEK for Fuchs’ endothelial dystrophy : a meta-analysis

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dc.contributor.authorMarques, Raquel Esteves
dc.contributor.authorGuerra, Paulo Silva
dc.contributor.authorSousa, David Cordeiro
dc.contributor.authorGonçalves, Ana Inês
dc.contributor.authorQuintas, Ana Miguel
dc.contributor.authorRodrigues, Walter
dc.date.accessioned2020-12-10T13:30:58Z
dc.date.available2020-12-10T13:30:58Z
dc.date.issued2018
dc.description© The Author(s) 2018. Reprints and permissions: sagepub.co.uk/journalsPermissions.navpt_PT
dc.description.abstractPurpose: To compare the safety and efficacy profiles of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in adult patients with Fuchs’ endothelial dystrophy. Methods: Electronic database search on MEDLINE and CENTRAL from inception to August 2017. We included all comparative studies of DMEK versus DSAEK in patients with diagnosed Fuchs’ endothelial dystrophy. Studies assessing rescue procedures were excluded to minimize bias. Primary outcome: mean difference in best-corrected visual acuity (BCVA) at 3, 6, and 12months postoperatively. Secondary outcomes: rates of graft primary failure, rejection, and rebubbling; other graft-related issues; mean difference in endothelial cell density; subjective visual outcomes; and patient satisfaction. Results: A total of 10 retrospective studies of moderate methodological quality were included (n=947 eyes, 646 DMEK). BCVA was better with DMEK at all evaluated time points (0.16 logMAR at 12months) comparing to DSAEK (0.30 logMAR; p<0.001). DMEK had a 60% lower rate of rejection (risk ratio (RR) 0.4, 95% CI (0.24, 0.67), p=0.0005), but required more rebubblings (RR=2.48, 95% CI (1.32, 4.64), p=0.005). DMEK had more primary graft failures and less endothelial cell density loss, but statistical difference was not reached. More patients were satisfied after DMEK (odds ratio=10.29, 95% CI (3.55, 29.80), p<0.0001). Conclusion: DMEK showed better postoperative results regarding BCVA, patient satisfaction, and graft-related issues. However, the small number of studies with short follow-up times and other methodological issues prompt us to interpret these results carefully.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Ophthalmol. 2019 Jan;29(1):15-22pt_PT
dc.identifier.doi10.1177/1120672118757431pt_PT
dc.identifier.eissn1724-6016
dc.identifier.issn1120-6721
dc.identifier.urihttp://hdl.handle.net/10451/45237
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Journalspt_PT
dc.relation.publisherversionhttps://journals.sagepub.com/home/ejopt_PT
dc.subjectCorneal transplantationpt_PT
dc.subjectDescemet stripping automated endothelial keratoplastypt_PT
dc.subjectDescemet membrane endothelial keratoplastypt_PT
dc.subjectFuchspt_PT
dc.titleDMEK versus DSAEK for Fuchs’ endothelial dystrophy : a meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage22pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage15pt_PT
oaire.citation.titleEuropean Journal of Ophthalmologypt_PT
oaire.citation.volume29pt_PT
person.familyNameEsteves Marques
person.familyNameSousa
person.givenNameRaquel
person.givenNameDavid Cordeiro
person.identifier707480
person.identifier.ciencia-idDF1D-9635-8FC4
person.identifier.orcid0000-0002-1445-7592
person.identifier.orcid0000-0002-7680-0325
person.identifier.ridN-4878-2016
person.identifier.ridA-6192-2015
person.identifier.scopus-author-id57202704272
person.identifier.scopus-author-id57188627862
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5e35a164-b2c3-447a-8f00-c507aaa14180
relation.isAuthorOfPublicationea222ec3-f323-4645-843f-3cd7ddc200ab
relation.isAuthorOfPublication.latestForDiscoveryea222ec3-f323-4645-843f-3cd7ddc200ab

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