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Y. Tomita, T. Yamaguchi, Y. Matsumoto, K. Negishi, S. Shimmura, Y. Uchino, D. Murat, K. Tsubota; Anterior and Posterior Surface Irregularity of the Cornea Before and After Descemet’s Stripping Automated Endothelial Keratoplasty and Its Correlation With Postoperative Visual Acuity and the Duration of Bullous Keratopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):775.
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To evaluate the anterior and posterior surface irregularity of cornea before and after Descemet’s stripping automated endothelial keratoplasty (DSAEK) and its correlation with postoperative visual acuity and the duration of bullous keratopathy.
This clinical study comprised 23 consecutive eyes of 22 bullous keratopathy patients. Corneal topographic data were acquired using a rotating Scheimpflug camera before,1month and 3 months after DSAEK. Anterior and posterior corneal elevation data were decomposed into a set of Zernike polynomials up to 8th order within a region of 4mm in diameter. Total higher-order root mean square (defined as "HO-RMS"; 3rd to 8th) and RMS from 3rd to 8th order were calculated and compared with normal control (age-matched 13 normal eyes). Its correlations with LogMAR best spectacle corrected visual acuity(BSCVA) and the duration of bullous keratopathy (DBK) were evaluated.
The average pre and postoperative BSCVA at 3 months were 1.05±0.45. and 0.33±0.28, respectively. The irregular astigmatism of the anterior corneal surface significantly decreased from 1 month after DSAEK (p<0.05), with a significant increase at 1 month(p<0.05) and slight decrease at 3 months for the posterior corneal surface after DSAEK. Postoperative BSCVA significantly correlated with HO-RMS and especially correlated with the postoperative 3rd and 4th order RMS of the anterior corneal surface. However there was no significant correlation between postoperative BSCVA and HO-RMS of the posterior corneal surface. Both age and DBK did not significantly correlate with the postoperative BSCVA and HO-RMS of the anterior corneal surface.
After DSAEK, the irregularity improved in both the anterior and posterior corneal surfaces. The postoperative visual acuity appears to be influenced by the irregularity of the anterior corneal surface.
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