{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:09:58Z","timestamp":1790140198515,"version":"4.0.1"},"reference-count":22,"publisher":"BMJ","issue":"5","funder":[{"name":"Jochum Jensen og hustru Mette Marie Jensen f. Poulsens Mindelegat","award":["None"],"award-info":[{"award-number":["None"]}]},{"DOI":"10.13039\/100019562","name":"Synoptik-Fonden","doi-asserted-by":"publisher","award":["None"],"award-info":[{"award-number":["None"]}],"id":[{"id":"10.13039\/100019562","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kirsten Friis-Nielsens Forskningsfond","award":["None"],"award-info":[{"award-number":["None"]}]},{"name":"Helene og Viggo Bruuns Fond","award":["None"],"award-info":[{"award-number":["None"]}]},{"name":"Fight for Sight Denmark","award":["None"],"award-info":[{"award-number":["None"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,5,29]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare best-corrected visual acuity (BCVA), contrast sensitivity and endothelial cell density (ECD) after ultrathin Descemet\u2019s stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet\u2019s membrane endothelial keratoplasty (DMEK).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomised, single-blinded, single-centre design was used. 72 patients with Fuchs\u2019 endothelial dystrophy and cataract were randomised to UT-DSAEK or DMEK combined with phacoemulsification and lens implantation. 27 patients with cataract were included in a control group and treated with phacoemulsification and lens implantation. The primary outcome was BCVA at 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with UT-DSAEK, DMEK resulted in better BCVA with mean differences of 6.1 early treatment diabetic retinopathy study (ETDRS) (p=0.001) after 3 months, 7.4 ETDRS (p&lt;0.001) after 6 months and 5.7 ETDRS (p&lt;0.001) after 12 months. The control group obtained significantly better BCVA with a mean difference of 5.2 ETDRS (p&lt;0.001) compared with DMEK 12 months postoperatively. Compared with UT-DSAEK, contrast sensitivity was significantly better 3 months after DMEK with a mean difference of 0.10 LogCS (p=0.03). However, our study found no effect after 12 months (p=0.08). ECD was significantly lower after UT-DSAEK compared with DMEK with mean differences of 332 cells\/mm<jats:sup>2<\/jats:sup>(p&lt;0.01) after 3 months, 296 cells\/mm<jats:sup>2<\/jats:sup>(p&lt;0.01) after 6 months and 227 cells\/mm<jats:sup>2<\/jats:sup>(p=0.03) after 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with UT-DSAEK, DMEK resulted in better BCVA 3, 6 and 12 months postoperatively. Twelve months postoperatively, DMEK had a higher ECD than UT-DSAEK; however, no difference in contrast sensitivity was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04417959\">NCT04417959<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2023-323304","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T17:20:14Z","timestamp":1686244814000},"page":"654-661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Visual function after ultrathin Descemet\u2019s stripping automated endothelial keratoplasty or Descemet\u2019s membrane endothelial keratoplasty combined with cataract surgery: a randomised controlled clinical trial"],"prefix":"10.1136","volume":"108","clinical-trial-number":[{"clinical-trial-number":"nct04417959","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1858-0464","authenticated-orcid":false,"given":"Morten Brok Molbech","family":"Madsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Ivarsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper","family":"Hjortdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"2024082217252058000_108.5.654.1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181f236c6"},{"key":"2024082217252058000_108.5.654.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.11.030"},{"key":"2024082217252058000_108.5.654.3","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/ICO.0000000000001793","article-title":"Retrospective single-center registry study on graft thickness 1 year after descemet stripping automated endothelial keratoplasty","volume":"38","author":"Gormsen","year":"2019","journal-title":"Cornea"},{"key":"2024082217252058000_108.5.654.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.05.019"},{"key":"2024082217252058000_108.5.654.5","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002601"},{"key":"2024082217252058000_108.5.654.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.02.029"},{"key":"2024082217252058000_108.5.654.7","doi-asserted-by":"crossref","unstructured":"Pesudovs K , Marsack JD , Donnelly WJ , et al . 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