Anterior Segment Optical Coherence Tomography (AS OCT) Findings After Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK)

Abstract

Purpose: : To report anterior segment Optical Coherence Tomography (AS OCT) findings and results of Descement Stripping with Automated Endothelial Keratoplasty (DSAEK) combined with phacoemulsification in cataract patients with Fuchs’ endothelial dystrophy

Methods: : Twelve eyes of eleven patients (one after bilateral procedures) with at least one year follow-up were reviewed. Measured parameters included best spectacle corrected visual acuity (BSCVA), refractive spherical equivalent (SE) and predictability, anterior corneal keratometric values, complications, and AS OCT findings.

Results: : Mean follow up was 14.33 months (range, from 12 to 18 months). BSCVA was unchanged (8%) or improved (92%) in all eyes compared with the preoperative levels. A discrepancy between the targeted postoperative refraction and the actual postoperative spherical equivalent (SE) refraction (hyperopic shift) of +1.46 D+ 0.76 D (range, -0.05 to +3.14) was observed. There was a significant correlation between the ratio of central versus the average peripheral donor corneal lenticule thickness (described as Central/Peripheral ratio at 3mm zone) and induced hyperopic shift (r=-0.81, p=0.001).

Conclusions: : DSAEK combined with phacoemulsification and IOL implantation in patients with coexisting Fuchs’ endothelial dystrophy and cataracts improved BSCVA without progressive time-dependent complications. There is a correlation between donor corneal lenticule shape and induced hyperopic shift.

Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • cornea: clinical science