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Seth M. Pantanelli, Ramkumar Sabesan, Xiaowei Cai, Geunyoung Yoon, Holly B. Hindman; Improvement in Visual Performance With Wave Aberration Correction 3-months and 1-year After Penetrating (PK), Deep Anterior Lamellar (DALK), or Descemet’s Stripping with Automated Endothelial Keratoplasty (DSAEK). Invest. Ophthalmol. Vis. Sci. 2011;52(14):2846.
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To quantify improvement in best-corrected visual acuity (VA) and contrast sensitivity (CS) with higher-order aberration (HOA) correction 3-months and 1-year after PK, DALK, or DSAEK surgeries.
Eyes from separate individuals were measured 3-months (DALK n=2, DSAEK n=2, PK n=2) and greater than 1-year (DALK n=6, DSAEK n=5, PK n=5) postoperatively. An adaptive optics (AO) system that corrects the ocular higher order aberration non-invasively was used and VA and CS were measured. For each subject, VA and CS were measured with and without AO correction. CS was measured at each of three spatial frequencies: 4, 8, and 12 cycles/degree.
Three months after surgery, benefit in VA from HOA correction approached significance in PK eyes (p=0.06), but not in DALK or DSAEK eyes. After one year, all post-op populations experienced statistically significant VA gains with HOA correction (p < 0.01). After one year, PK subjects had significantly better VA than DSAEK subjects before HOA correction (logMAR VA 0.02 ± 0.10 vs. 0.25 ± 0.11; p < 0.05); after HOA correction this trend persisted, although the difference was no longer significant (p=0.06). Despite having the same HORMS as DALK, and less HORMS than PK, DSAEK subjects experienced less VA benefit from HOA correction. Contrast sensitivity experiments suggest that all post-op populations benefit similarly from HOA correction despite having different HORMS magnitudes.
After 1-year, despite greater HOA, PK eyes had significantly better logMAR VA than DSAEK eyes without AO correction. When AO was applied this trend persisted, though did not reach significance (p=0.06). This suggests a greater contribution of scatter to decrements in VA with DSAEK. The increased scatter with DSAEK may result from donor-host corneal stromal interactions.
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