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Maxime SOT, Louis Lhuillier, Naïla Houmad, Mohamed Zaidi, Alix EHRHARDT, Oualid Guechi, adina agapie, Piotr Krawczyk, Nadia OUAMARA, Jean-Marc Perone; Impact of graft thickness on visual gain after Descemet's stripping automated endothelial keratoplasty.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1211.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study to determinate if there is a correlation between visual acuity gain in patients who underwent a Descemet's stripping automated endothelial keratoplasty (DSAEK) corneal keratoplasty and the central thickness of the graft.
Were included in this study eyes who underwent a DSAEK for endothelial dysfunctions indication (mainly acquired after phacoemulsification or for Fuchs dystrophy) between early 2012 and mid 2015 at CHR Metz-Thionville (Mercy Hospital) Were excluded eyes presenting pathologies (e.g. Age-Related Macular Degeneration, or diabetic macular edema) which are known to induce visual acuity decrease, non-related to the success of the graft and graft failure cases. Central graft thickness was measured in Anterior Segment Optical Coherence Topography (AS-OCT RS-3000 Nidek). Visual acuity gain was defined by the differential between pre-operative visual acuity (VA) and post operative best corrected visual acuity (BCVA) obtained during post-operative visits.
Fourty eight patients (48 eyes) who underwent DSAEK were included. Mean age was 74 years (+/- 11 y). 71% were women. Pre-operative median visual acuity was 0.70 LogMAR (range 0.40 – 2.30). Post-operative median visual acuity was 0.40 LogMAR (range 0.05 – 1.00). Median visual acuity gain was 0.43 logMAR (range 0.00 – 1.60). Mean Central Graft Thickness was 129.6 µm (SD 59.7; range 45 - 302). BCVA was obtained 341.6 days (SD 227.8) after surgery.A Pearson correlation test between Visual Acuity Gain and Central Corneal Thickness did not show any correlation between these two parameters: correlation coefficient = 0.00028 IC95 [-0.352; 0.357], p-value = 0.99.
Visual acuity gain after DSAEK lamellar keratoplasty does not seem to be correlated to the graft thickness. There was a strong statistical absence of correlation between these two parameters. It doesn't seem interesting to try to lower the thickness of the graft (like in ultra thin DSAEK) in order to obtain better post-operative visual acuities. There might exist other parameters that influence the visual acuity gain after DSAEK such as optical aberration of high level and hyper-reflectivity in the interface.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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