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R.L. Armour, M.S. Wertheim, W.D. Mathers, P.J. Ousley, M.A. Terry; Deep Lamellar Endothelial Keratoplasty (DLEK) Reduces Total and Higher Order Aberrations . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2708.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The amount and significance of corneal aberration following deep lamellar endothelial keratoplasty (DLEK) was evaluated by Wavefront analysis. Total and higher order aberration were correlated with post–operative vision. The extent of aberration was compared to fellow penetrating keratoplasty (PK) eyes. Methods: Sixteen eyes of nine DLEK patients were evaluated by Wavefront analysis using an Alcon LADARWave Custom Cornea Wavefront System. Twelve eyes had DLEK, 2 had PK, and 2 had Fuchs’ dystrophy, but no prior transplantation surgery. The post–operative interval for the 12 DLEK eyes ranged from 6 months to 3 years with an average of 21 months. Best spectacle corrected visual acuity (BSCVA) was correlated with total and higher order aberrations. Results: The average post–operative vision in the DLEK eyes was 20/35 (range, 20/20 to 20/80). Both total and higher order aberrations in DLEK eyes were low. The mean total aberrations for the DLEK eyes was 1.55 Root Mean Square (RMS) microns (µm) (range, 0.57 to 3.42). The mean higher order aberrations for the DLEK eyes was 0.55 RMS µm (range, 0.3 to 0.94). Neither total aberrations nor higher order aberrations correlated significantly with vision (r=0.308, p=0.330 and r=0.487, p=0.108, respectively). The total aberrations for the two PK eyes were 1.95 and 3.92 RMS µm and the higher order aberrations were 0.85 to 1.26 RMS µm. PK resulted in greater total aberrations (p=0.095) and significantly greater higher order aberrations (p=0.045) compared to DLEK. Two patients had a history of DLEK in one eye and Fuchs’ dystrophy in the fellow eye. In both patients, the clear DLEK eye had less aberration than the Fuchs’ dystrophy eye with stromal edema. Conclusions: Wavefront analysis reveals that corneal aberration after DLEK is minimal. DLEK results in better preservation of the anterior corneal surface topography and less total and higher order aberration compared to PK.
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