Pentacam Characterization of Corneas with Fuchs Dystrophy Treated with Descemet Membrane Endothelial Keratoplasty

Abstract

To characterize central corneal thickness, curvature, and posterior surface elevation in eyes with Fuchs dystrophy that underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial decompensation and to compare these characteristics with those in normal eyes. Pre- and postoperative corneal tomography was prospectively evaluated using Pentacam (Oculus Optikgeräte GmbH) imaging on 29 eyes with Fuchs dystrophy treated with DMEK. Results were compared with data from a separate cohort of 198 normal eyes. In the Fuchs cohort, the mean preoperative central corneal thickness was 656 μm (range: 574 to 731 μm). This significantly exceeded the mean thickness of 542 μm in the normal cohort (range: 439 to 611 μm, P<.0001) although the cohort thickness ranges overlapped. One month after DMEK, mean central corneal thickness decreased significantly to 539 μm (range: 465 to 669 μm, P<.0001) with no further significant decrease between 1 and 3 months after DMEK (mean difference = -4 μm, P=.39). In the Fuchs cohort, keratometry (average Sim K and delta K) did not change significantly after DMEK (P=.41 and P=.44, respectively); pre- and postoperative values were comparable to those in the normal cohort. The mean forward displacement of the posterior surface increased by 69 μm 1 month after DMEK (P<.0001) without further significant change between 1 and 3 months. After DMEK, central corneal thickness in the Fuchs dystrophy cohort decreased significantly and the posterior corneal surface displaced forward, without significant change in anterior keratometric values or keratometric astigmatism. The preoperative central corneal thickness range in eyes with confluent central guttata overlapped the range in normal corneas.