Thickness Measurements of Donor Posterior Disks After Descemet Stripping Endothelial Keratoplasty With Anterior Segment Optical Coherence Tomography

Abstract

To evaluate donor posterior disk thickness measured with anterior segment optical coherence tomography after Descemet stripping endothelial keratoplasty. Fifteen patients (17 eyes) after Descemet stripping endothelial keratoplasty, using manually dissected donor posterior disks, were measured with the Visante anterior segment optical coherence tomography (Carl Zeiss Meditec Inc, Dublin, CA). Optical coherence tomography scans were made in a radial pattern, 45 degrees apart, starting in the horizontal axis. Thickness measurements of the donor posterior disks were taken centrally and at fixed radii toward the periphery and were correlated to postoperative change in spherical equivalent (SE), best-corrected visual acuity (BCVA, in Snellen), and improvement in BCVA. Median BCVA was 20/30 (range 20/60-20/20) postoperatively. Median postoperative improvement in BCVA was 4 lines (range 1-11). Median follow-up time was 15.5 months (range 6-32 months). Median postoperative change in SE was -0.25 diopters (range -4.25 to +3.00 diopters). Median central disk thickness was 128.3 microm (range 55-181 microm) and increased significantly toward the periphery: median disk thickness at the 1.5 mm radius was 140.8 microm (range 72-199 microm) and at the 3.0 mm radius was 161.5 microm (range 102-245 microm). No correlation was found between (central) donor disk thickness and postoperative BCVA or change in SE. A nonstatistically significant trend was seen toward more improvement in BCVA with thinner donor disks. Optical coherence tomography measurements of the manually dissected donor posterior disk showed significant variation in thickness, without a statistically significant effect on postoperative BCVA or improvement thereof. Central thickness varied significantly from the peripheral thickness within donor posterior disk.