Anterior-Segment Optical Coherence Tomography Investigation of Corneal Deturgescence and Epithelial Remodeling After DSAEK

Abstract

The aim of this study was to evaluate via Fourier-domain anterior-segment optical coherence tomography 3-dimensional corneal, epithelial, and graft thickness changes after Descemet stripping automated endothelial keratoplasty (DSAEK). Sixteen eyes were investigated preoperatively and up to 6 months postoperatively for preoperative and postoperative central corneal thickness (CCT), minimum corneal thickness, central graft thickness (CGT), and for epithelial topographic thickness variability. An age-matched and gender-matched control group of 32 healthy eyes was used for comparison. In the DSAEK group, the preoperative CCT was 582.32 ± 45.24 (550-615) μm. One-month postoperatively, the CCT was 736.26 ± 34.52 (713-771) μm, and the CGT was 210.42 ± 34.52 (145-243) μm. Three months postoperatively, the CCT was 641.39 ± 38.75 (569-684) μm, and the CGT was 171.23 ± 27.54 (119-185) μm. The preoperative center epithelial thickness was 55.74 ± 9.29 (45-74) μm, the minimum was 32.53 ± 14.30 (13-53) μm, the maximum was 76.00 ± 11.32 (64-105) μm, and the topographic thickness variability was 10.84 ± 4.09 (5.90-18.80) μm. Three months postoperatively, the center epithelial thickness was 47.21 ± 5.45 (43-56) μm, the minimum was 35.11 ± 4.70 (30-41) μm, the maximum was 58.11 ± 6.51 (49-65) μm, and the topographic variability was 4.77 ± 1.48 (2.90-6.50) μm. The average differences were -8.53, +4.53, and -17.89 μm for the center, minimum, and maximum (P < 0.001, <0.001, and <0.001). Similar results were obtained 3 and 6 months postoperatively. We present a near-term postoperative investigation of the corneal and epithelial thickness changes after DSAEK for bullous keratopathy, by in vivo, clinical anterior-segment optical coherence tomography. Epithelial thickness recovery and normalization and corneal deturgescence were noted as early as in the first postoperative month.