Anterior Chamber Characteristics, Endothelial Parameters, and Corneal Densitometry After Descemet Stripping Automated Endothelial Keratoplasty in Patients With Fuchs Dystrophy.

Remzi Karadag,Kristin M Hammersmith,Parveen K Nagra,Christopher J Rapuano

doi:10.18502/jovr.v16i2.9078

Abstract

PurposeTo compare anterior segment parameters in patients with Fuchs endothelial dystrophy (FED) who underwent Descemet stripping automated endothelial keratoplasty (DSAEK) in one eye and no corneal surgery in the fellow eye.MethodsThis prospective study was conducted on 28 eyes of 14 patients with FED who underwent DSAEK in one eye at least one year prior (DSAEK group) and no corneal surgery in the fellow eye (control group). Each eye was analyzed with the anterior segment optical coherence tomography, specular microscopy, and Scheimpflug imaging systems. Data were compared between the two groups.ResultsThe mean age of the patients was 76.9 7.0 years. There were no statistically significant differences in the mean central corneal thickness (CCT), central anterior chamber depth, anterior chamber angle parameters, cylinder and keratometry values between two groups (all P-values 0.05). The paracentral corneal thickness, corneal volume, endothelial cell density, and hexagonal cell ratio measurements were statistically significantly higher in the DSAEK group than the control (all P-values < 0.05), and anterior chamber volume in the DSAEK group was significantly less than the control (P = 0.046). While posterior and total corneal densitometry values in the DSAEK group were statistically significantly lower than the control (P < 0.001 and P = 0.011, respectively), there were no statistically significant differences in the anterior or middle corneal densities (P = 0.108 and P = 0.134, respectively).ConclusionWe found that total corneal densitometry value decreased in DSAEK group. Although DSAEK surgery did not affect the anterior chamber angle parameters, it reduced the anterior chamber volume and increased the corneal volume and paracentral corneal thickness due to the addition of the DSAEK graft.

Highlights

Fuchs endothelial dystrophy (FED) is a fairly common corneal disorder that can result in visual impairment and require corneal transplantation.[1]
Descemet stripping automated endothelial keratoplasty (DSAEK) surgery was performed in nine right and five left eyes
Fuchs endothelial dystrophy is a common indication for keratoplasty in developed countries

Summary

Introduction

Fuchs endothelial dystrophy (FED) is a fairly common corneal disorder that can result in visual impairment and require corneal transplantation.[1]. Descemet stripping automated endothelial keratoplasty (DSAEK) is one of the most commonly performed posterior lamellar surgeries for FED This method involves the replacement of the posterior diseased part of the cornea with donor endothelium, Descemet membrane, and a small amount of stroma.[2] This technique has a number of advantages over penetrating keratoplasty (PK), including less induced astigmatism, fewer suture-related complications, fewer high-order aberrations, faster visual rehabilitation, and a stronger wound.[2, 3] In the literature, a few studies have investigated biomechanical properties and keratometry of cornea, and some anterior segment (AS) parameters after the DSAEK surgery in patients with FED.[4, 4,5,6,7] Some studies have shown that DSAEK leads to a small hyperopic shift,[4, 5] residual corneal aberrations, glare and reduced contrast sensitivity compared to normal.[6, 7] To the best of our knowledge, no studies have characterized the anterior chamber and corneal parameters using three different devices after DSAEK surgery in one eye in patients with FED

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