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Friedrich E Kruse, Anja Katharina Gruenert, Michael Rudolph, Julia Marina Weller, Johannes Menzel-Severing, Theofilos Tourtas; Long-term changes of corneal higher-order aberrations after Descemet’s Membrane Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Since the surgical technique of Descemet’s Membrane Endothelial Keratoplasty (DMEK) has been introduced, numerous studies have been published evaluating short-term outcomes. However, at present only a few data are available regarding long-term outcomes. In this study we analyzed the long-term development of corneal higher-order aberrations (HOAs) after DMEK.
We performed a retrospective single-center study including 98 eyes of 85 consecutive patients who underwent DMEK. Main outcome measures were HOAs in the central 4-mm zone of the posterior corneal surface during a 5-year-follow-up. HOAs were analyzed using the Pentacam high-resolution rotating Scheimpflug imaging system (Pentacam HR, Oculus, Wetzlar, Germany). Data were compared using Wilcoxon rank sum test.
Mean follow-up time was 43.56±15.99 months. Mean total posterior corneal aberration (RMS CB) decreased significantly from 0.267±0.164 µm before surgery to 0.182±0.993 µm (p<0.001,) 3 months after DMEK and mean HOAs of the posterior corneal surface (RMS HOA CB) decreased significantly from 0.083±0.069 µm to 0.057±0.030 µm (p<0.001), respectively. Until 24 months after DMEK, no significant changes in corneal aberrations were found. Between 24 and 36 months postoperatively mean RMS HOA CB increased significantly from 0.054±0.033 µm to 0.065±0.045 µm (p=0.030) whereas mean RMS CB did not change significantly. Within the following year mean RMS HOA CB increased further significantly to 0.079±0.061 µm (p=0.021) while mean RMS CB increased significantly from 0.181±0.145 µm to 0.205±0.138 µm (p=0.030). In the period from 48 to 60 months after DMEK corneal aberrations remained stable.
In the first three months following DMEK surgery corneal aberrations decreased significantly. This correlates well with a rapid increase of visual acuity. However, during the third and fourth postoperative year corneal aberrations increased again and afterwards remained stable throughout the fifth year. On the contrary, visual acuity remains stable over a period of four years. Future studies might provide an explanation for the changes of corneal aberrations after DMEK.
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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