Purchase this article with an account.
Yukiko Morita, Naoyuki Morishige, Tai-ichiro Chikama, Naoyuki Yamada, Norihisa Takahashi, Teruo Nishida, Koh-Hei Sonoda; Impact Of The Preoperative Duration Of Stromal Edema In Bullous Keratopathy On Early Visual Acuity After Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2012;53(14):46.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To clarify the relation between visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK) and the preoperative duration of stromal edema.
Twenty-eight subjects who underwent DSAEK were divided into two groups on the basis of a preoperative duration of stromal edema of <12 months (group A, n = 22) or ≥12 months (group B, n = 6). None of the subjects had postoperative conditions that might have affected the visual outcome of surgery. Best corrected visual acuity (BCVA) was measured at various times after surgery, and the morphology of the anterior cornea was evaluated by in vivo laser confocal microscopy.
BCVA in group A ranged from 20/50 to 20/16 at 3 months and from 20/66 to 20/16 at 6 months after surgery, with the maximal values being 20/40 to 20/13. BCVA in group B ranged from 20/66 to 20/40 at 3 and 6 months, with maximal values of 20/66 to 20/33. The structure of the anterior cornea was normal in subjects of group A but was abnormal, with fibroblastic cells apparent in the anterior stroma, in subjects of group B.
Patients with a preoperative duration of stromal edema of ≥12 months had pathological changes in the corneal stroma that may have adversely affected visual acuity after DSAEK. Given that stromal edema including that associated with bullous keratopathy has been proposed to be a progressive condition, DSAEK may be most effective when performed early after the onset of edema, before the occurrence of pathological changes in the stroma.
This PDF is available to Subscribers Only