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T. John, D. A. Taylor, M. Shimmyo, B. E. Siskowski; Corneal Hysteresis Following Descemetorhexis With Endokeratoplasty (DXEK) (Sutureless Corneal Transplant). Invest. Ophthalmol. Vis. Sci. 2007;48(13):4716.
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© ARVO (1962-2015); The Authors (2016-present)
To measure the corneal biomechanical properties of subjects following descemetorhexis with endokeratoplasty (DXEK).
100 eyes were studied (Groups 1 & 2). All DXEK patients were operated by a single surgeon (TJ) and the donor corneal disks were surgeon-cut, using the microkeratome and artificial anterior chamber (Moria, Inc., St. Antony, France). Descemetorhexis was performed using the John Dexatome (ASICO, Inc., Westmont, IL) in all eyes. None of the eyes had anterior corneal-slits to the host-donor interface. All subjects underwent corneal biomechanical evaluation with the Ocular Response Analyzer (ORA, Reichert, Inc., Depew, New York).
There were 12 eyes of 12 DXEK patients (Gr.1) and 88 eyes of 44 age-matched normal subjects (Gr.2). The demographics- Male/female: 8/4 (Gr.1), 18/26 (Gr.2); Age: (Av±SD) 71±9 yrs (Gr.1), 70±11.5 yrs (Gr.2); Age range: 55-87 yrs (Gr.1), 29-86 yrs (Gr.2); Post-op. days (Av±SD) 171±154 (Gr.1); Post-op. range 4-535 days (Gr.1). Corneal hysteresis (CH, Av±SD) 6.94±1.65 (Gr.1), 10.51±1.22 (Gr.2); CH range: 3.50-9.90 (Gr.1), 7.90-14.00 (Gr.2); Corneal resistance factor (CRF, Av±SD): 8.60±2.70 (Gr. 1), 9.86±1.23 (Gr.2); CRF range: 4.30-14.20 (Gr.1), 6.40-13.50 (Gr.2). CH and CRF measurements of all DXEK eyes were significantly lower than the normal eyes (P<0.00001).
ORA corneal hysteresis measurements were significantly lower in sutureless corneal graft patients, namely, DXEK than in normal subjects. DXEK has a direct effect on corneal hysteresis and corneal biomechanical properties of the human cornea. This is the first report of CH and CRF following DXEK surgery.
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