Purpose:
To evaluate the posterior lamellar donor thickness measured with the Visante anterior segment OCT in patients with Fuchs’ endothelial dystrophy after posterior lamellar keratoplasty (PLK).
Methods:
Patients following PLK, with manually dissected donor lamellae, were measured with the new anterior segment OCT (Visante OCT, Carl Zeiss Meditec). Four cross-sectional scans were made in a radial pattern, 45° apart. Thickness measurements were done centrally, and at 1.5 and 3 mm at both sides from the center. Thickness measurements were correlated with postoperative best-corrected visual acuity (BCVA in Snellen).
Results:
Seventeen eyes of 15 patients were included in the study. Median (range) BCVA was 0.25 (0.01-0.40) pre-operative, and 0.5 (0.32-0.80) postoperatively. Median follow-up time was 15.5 months (range 5-32 months). Fifteen eyes showed improvement of visual acuity after PLK, no patients had loss of vision. Median (range) lamellar thickness (at 180°) was 117 (64-183) micron in the center, and increased significantly towards the periphery (142 (77-334) micron, 130 (59-267) micron, 134 (92-260 micron) and 178 (93-309 micron) at -3, -1.5, 1.5 and 3 mm from the center respectively; Figure 1A). A trend was seen showing better postoperative BCVA with thinner central posterior lamellae (Figure 1B). Thickening of the lamellae towards the periphery had no influence on BCVA.
Conclusions:
This study shows that PLK, with manually dissected lamellae, in patients with decompensated Fuchs’ endothelial dystrophy is a successful procedure. OCT measurements of the lamellar thickness showed significant variance in central thickness compared to peripheral thickness, but this had no influence on postoperative BCVA. A trend was seen towards better postoperative BCVA with a thinner center of the lamellae.
Keywords: cornea: clinical science • imaging/image analysis: clinical