To compare clinical outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) between different graft insertion methods.

The clinical records of 32 eyes of 30 DSAEK patients were retrospectively analyzed. Patients were divided into 2 groups according to graft insertion method. Group A: Taco-folding, group B: Tan-endoglide. The best corrected visual acuities (BCVA), intraocular pressures, astigmatism, endothelial cell count, central corneal thickness and complications were evaluated pre and post-operatively.

The average follow-up period was 19 months (range 1-67). Postoperative log MAR visual acuity had significantly improved both from 1.63 (log MAR) to 0.69 and 0.53 at 12 months in each group ( p = 0.035, p = 0.000). Mean endothelial cell survival of each group at 1 month postoperative were 75.8% (range 62.7-88.6) and 87.7% (range 70.2-97.9), respectively ( p = 0.012). The differences of BCVA improvement and endothelial cell survival between the groups at 12 months were not significant ( p = 0.393, p = 0.544).

Both methods showed fast visual recovery. Using Tan-endoglide insertion resulted less endothelial cell loss at early post-operative period and showed less post-operative complication and graft failure.