Purchase this article with an account.
C. Mueller, W. Sekundo, A. Schulze, E. M. Hoffmann, N. Pfeiffer, J. Vetter; Impairment of Visual Acuity Due to Permanent Descemet Folds Following Descemet Stripping and Automated Endothelial Keratoplasty (DSAEK). Invest. Ophthalmol. Vis. Sci. 2010;51(13):758.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the correlation between the extent of postoperative endothelial folds and the best corrected visual acuity (BCVA) following descemet stripping and automated endothelial keratoplasty (DSAEK).
14 patients (4 male, 10 female) were followed up 12 month after DSAEK. The average follow-up was 467 days (range 327 to 727 days). Best corrected visual acuity was measured, endothelial cell count was obtained with a specular microscope (SP 3000, Topcon, Tokyo, Japan) and grafts were examined by fourier-domain optical coherence tomography (RTVue, Optovue, Fremont, USA). The mean height of all descemet folds in 4 corneal sections within the central 4x4 mm was extrapolated from the images. A correlation was assessed using Pearson by coefficient.
Mean visual acuity (LogMar) was 0.46 (standard deviation ± 0.22). Mean endothelial cell count was 1098 cells/ mm2 (± 610 cells/ mm2). On each examination, a mean of 5.6 folds (± 1.6) were visible within the optical zone. The mean height of descemet folds was 18.7 µm (± 13.7 µm). The correlation between BCVA and mean height of the descemet folds was 0.56 (p=0.037), while there was no correlation between BCVA and endothelial cell count (correlation coefficient 0.44).
Our results show that after DSAEK surgery descemet folds can persist in the graft. The data also suggest a connection between the extent of the folds and BCVA. Further research has to be performed in order to clarify the role of these folds in comparison with other visual acuity-limiting factors after DSAEK. Finally, a better understanding of the underlying mechanisms and prevention strategies is needed.
This PDF is available to Subscribers Only