Abstract
Purpose: :
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).
Methods: :
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.
Results: :
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).
Conclusions: :
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.
Keywords: cornea: clinical science • transplantation • cornea: endothelium