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HIROYUKI YAZU, Takefumi Yamaguchi, Murat Dogru, Yoshiyuki Satake, Jun Shimazaki; The association between posterior surface irregularity and degradation of visual acuity after same eye Descemet’s Stripping Automated Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4859. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the contribution of posterior corneal surface irregularity to higher-order aberrations (HOAs) and visual acuity after DSAEK in the same eyes.
31 patients who underwent DSAEK twice in the same eyes in Tokyo Dental College Department of Ophthalmology from 2008 to 2014 were studied（62 DSAEK in total). We investigated the HOAs of the anterior and posterior surfaces, and total cornea using the Fourier analysis from the data of the anterior segment optical coherence tomography (AS-OCT) in 46 DSAEK procedures of 23 patients (8 patients were excluded due to primary graft failure in the initial DSAEK). 23 Eyes were divided into one of the following groups in this study ; Group A : Eyes with an improvement of best corrected visual acuity (BCVA) ≧ 2 lines of the repeat DSAEK. Group B : Eyes with a decline of BCVA ≦ 2 lines of the repeat DSAEK. GroupC : Eyes with no change or change in BCVA within 1 line after DSAEK. Same examination parameters were also compared between initial and repeat DSAEK in eyes of groupC.
There were no significant differences in the anterior surface and total cornea HOAs between groupA and B (P=0.12 and 0.08), whereas the HOAs of the posterior surface in group B were significantly greater than those of group A (P=0.028). There were no significant differences in the anterior and posterior surface as well as total cornea HOAs between initial DSAEK and repeat DSAEK in groupC (P=0.87, 0.65 and 0.42). The BCVA had a significant correlation with the anterior and posterior surface as well as the total cornea HOAs (R=0.40, 0.46 and 0.53; P=0.01, 0.002 and 0.001).
Posterior corneal higher-order aberrations can have a negative influence on the visual acuity in the same eyes, suggesting the presence of heterogeneous graft thickness or folds in the graft as the cause of visual impairment.
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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