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T. Miyai, R. Nejima, Y. Mori, M. Ogata, K. Miyata, S. Shimmura, S. Amano; Quantitative Comparison of Postoperative Irregular Astigmatism Between Descemet’s Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty for Bullous Keratopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):740.
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Descemet’s stripping automated endothelial keratoplasty (DSAEK) is a surgery for bullous keratopathy that is supposed to induce less postoperative irregular astigmatism compared to penetrating keratoplasty (PK) because of the lack of sutures to attach the graft to the host cornea. However, quantitative comparative studies on irregular astigmatism between the two surgeries are few. This retrospective study aimed to compare quantitatively irregular astigmatism between DSAEK and PK.
Twenty-five corneal transplants comprising of 13 DSAEK and 12 PK for bullous keratopathy were included. In all DSAEK procedures, precut 8-mm-diameter donor posterior buttons were inserted with the pull-through technique using Busin glide through 4.1mm temporal corneal incision. In all PK procedures, 8-mm-corneal grafts were attached to host cornea trephinated in 7.5-mm-diameter-blades with running suture. Suture adjustment was performed before finishing surgery. Computerized videokeratography was taken at 1, 3 and 6 month postoperatively and the data were decomposed into spherical component, regular astigmatism, asymmetry, and higher-order irregularity using the Fourier series harmonic analysis.
Regular astigmatism, asymmetry and higher-order irregularity were statistically smaller in DSAEK than in PK at 1, 3 and 6 month. (p<0.05) In DSAEK, spherical component increased and regular astigmatism and higher-order irregularity decreased at 3 and 6 month compared to 1 month. (p<0.05) In PK, higher-order irregularity decreased at 3 and 6 month compared to 1 month. (p<0.05)
Both regular and irregular astigmatism in DSAEK was smaller than in PK. Time-course changes of astigmatism from postoperative 1 month to 6 month showed different pattern between DSAEK and PK.
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