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M. A. Di Pascuale, Y. Pessach, V. V. Mootha; Early Intraocular Pressure, Corneal and Anterior Chamber Changes After Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK). Invest. Ophthalmol. Vis. Sci. 2010;51(13):4632.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate intraocular pressure, central corneal thickness (CCT), central endothelial graft thickness and anterior chamber changes after DSAEK in the early postoperative period using the new commercially available VisanteTM anterior segment optical coherence tomography. (Carl Ziess Meditec AG, Jena, Germany).
We included 19 eyes from 19 patients (9 males, 10 females, with mean ages of 78.8±12.5 years old). Thirteen patients had preoperative diagnosis of Fuchs endothelial dystrophy and 5 patients had bullous keratopathy and 1 patient had a failed corneal graft. DSAEK alone was performed in 6 eyes and DSAEK with phacoemulsification and posterior chamber intraocular lens implantation was performed in 13 eyes. In each visit, VA, IOP measured by pneumotonometry (Mentor®, Norwell, MA, US), slit lamp examination and anterior segment OCT evaluation including CCT, ACD and anterior chamber angle were performed. Successful DSAEK was defined as an anatomically attached endothelial graft (EG) with a clear and compact slit lamp cornea appearance.
Mean follow-up time was 3.4 ±3.1 months. Preoperative IOP increased from 15.8±4.1 mmHg to 19.1±5.4 mmHg at the last visit, and the preoperative central corneal thickness (CCT) decreased from 684.2±72.7µm to 668.7±99.8 µm. At the first day, the IOP decreased 0.4 mm Hg and continue to slow down 0.3 mm Hg in the first week. After the first week, IOP increased to 3 mm Hg in the first month period and continue to increase 1.4 mm Hg between 1 to 3 months, and during the last visit IOP slightly decreased 0.4 mm Hg. Central corneal thickness decreased significantly from the first day (904.2±184.5 µm) to the last visit (668.7±99.8 µm) (P< 0.0001) . The greater decrease of CCT was observed during the first week (220 µm), followed at 1 month (136.4 µm) and 3 months to the last visit (57.9 µm).As well as CCT, the central EG thickness decreased significantly from the first day (245.2±91.7 µm) to the last visit (151.8±51.4 µm) (P= 0.0001). The greater decrease of central EG was observed during the first week (48 µm), followed at 1 month (39.6 µm) and 3 months to the last visit (15.1 µm). Preoperative and last visit anterior chamber changes results will be presented.
This study revealed that after DSAEK there was a steady increase of IOP after the first week that tend to stabilized at 3 months, interestingly this was associated with a greater deturgence of the central corneal and central EG during first week with a tendency of stabilization of CCT and EG thickness at 3 months of follow up.
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