Abstract
PurposeTo assess the relationship of intraocular forward scattering and corneal higher-order aberrations (HOAs) with best spectacle corrected visual acuity (BSCVA) after Descemet’s stripping automated endothelial keratoplasty (DSAEK), and to compare these parameters between DSAEK and non-Descemet’s stripping automated endothelial keratoplasty (n-DSAEK) groups.MethodsThis retrospective study enrolled thirty eyes of 30 consecutive patients who underwent standard DSAEK, and who underwent successful phacoemulsification with intraocular lens implantation before DSAEK. The mean age at the time of surgery was 71.7 ± 10.4 years. We quantitatively evaluated the objective scattering index (OSI) using the double-pass instrument (OQAS II, Visiometrics) and corneal HOAs using Hartmann-Shack aberrometry (KR-9000PW, Topcon) 3 months postoperatively.ResultsThe mean OSI, corneal HOAs, and logMAR BSCVA 3 months after DSAEK were 7.91 ± 3.58, 0.43 ± 0.27 μm, and 0.32 ± 0.25, respectively. We found a significant correlation between the OSI and logMAR BSCVA (Spearman correlation coefficient r=0.714, p<0.001), but no significant association between corneal HOAs and logMAR BSCVA 3 months postoperatively (r=0.209, p=0.267). We found no significant differences in any postoperative parameters between the DSAEK and n-DSAEK groups (p>0.05).ConclusionsOur pilot study demonstrated that the postoperative corrected visual acuity was significantly correlated with intraocular forward scattering, but not with corneal HOAs in post-DSAEK eyes, suggesting that intraocular forward scattering plays a more essential role in postoperative visual performance than corneal aberrations after DSAEK. The detailed visual performance, such as HOAs and intraocular scattering, after n-DSAEK appears to be essentially equivalent to that after DSAEK.
Highlights
Descemet’s stripping automated endothelial keratoplasty (DSAEK) has been reported to be effective for the treatment of corneal endothelial dysfunction.[1,2,3] This surgical technique has several surgical advantages over penetrating keratoplasty (PK) in terms of faster visual rehabilitation, less surgically-induced astigmatism, less induction of graft rejection, and preservation of biomechanical properties
We found a significant correlation between the objective scattering index (OSI) and logMAR best spectaclecorrected visual acuity (BSCVA) (Spearman correlation coefficient r=0.714, p
We found no significant differences in any postoperative parameters between the DSAEK and non-Descemet’s stripping automated endothelial keratoplasty (n-DSAEK) groups (p>0.05)
Summary
Descemet’s stripping automated endothelial keratoplasty (DSAEK) has been reported to be effective for the treatment of corneal endothelial dysfunction.[1,2,3] This surgical technique has several surgical advantages over penetrating keratoplasty (PK) in terms of faster visual rehabilitation, less surgically-induced astigmatism, less induction of graft rejection, and preservation of biomechanical properties. We do encounter some patients whose best spectaclecorrected visual acuity (BSCVA) was not very good, even when the transparency of the donor and recipient corneas appeared to be excellent after DSAEK in a clinical setting. This may be attributed to the induction of higher-order aberrations (HOAs) and/or light scattering by the cornea, especially by the anterior stroma and the interface between the donor and recipient corneas. The purpose of the present study is twofold: to retrospectively assess the relationships of intraocular forward scattering and corneal HOAs with corrected visual acuity in post-DSAEK eyes, and to compare these optical parameters between the DSAEK and n-DSAEK groups
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