Abstract
Purpose: :
To compare the visual outcomes of DSAEK and penetrating keratoplasty (PKP).
Methods: :
Twenty-two eyes of 22 patients who underwent DSAEK and 21 eyes of 21 patients who underwent PKP for bullous keratopathy at Yamaguchi University Hospital were evaluated retrospectively from medical records for visual acuity, subjective astigmatism, and corneal front curvature as determined with a corneal topographer (TMS-4, TOMEY). The surface asymmetry index (SAI), surface regularity index (SRI), and irregular astigmatism index (IAI) were also obtained with the TMS-4.
Results: :
Mean best corrected visual acuity improved from 0.05 to 0.40, 0.48, and 0.58 at 3, 6, and 12 months, respectively, after DSAEK, and from 0.04 to 0.36, 0.41, and 0.44 at the corresponding times after PKP. Mean subjective astigmatism changed from 1.35 to 1.63, 1.32, and 1.40D at 3, 6, and 12 months, respectively, after DSAEK, and from 1.23 to 3.71, 3.39, and 2.93D after PKP; the values at 3 and 6 months differed significantly (P<0.01) between the two procedures. Mean SAI improved from 3.32 to 1.40, 1.65, and 1.02 at 3, 6, and 12 months, respectively, after DSAEK, but it only changed from 2.50 to 2.83, 2.50, and 2.10 after PKP; the values at all three time points differed significantly (P<0.05) between the two procedures. Mean SRI improved from 1.92 to 1.04, 1.05, and 0.82 at 3, 6, and 12 months after DSAEK, but it only changed from 1.84 to 1.88, 1.92, and 1.87 after PKP; the values at all three time points differed significantly (P<0.05) between the two procedures. Finally, mean IAI improved from 0.85 to 0.63, 0.63, and 0.55 at 3, 6, and 12 months after DSAEK, but it only changed from 0.91 to 0.92, 0.93, and 0.89 after PKP; the values at all three time points differed significantly (P < 0.01) between the two procedures.
Conclusions: :
Despite a greater improvement in corneal surface regularity in eyes treated with DSAEK, postoperative corrected visual acuity did not differ between DSAEK and PKP, suggesting that other factors such as the presence of stromal opacity may limit visual acuity after DSAEK .