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Natsume Suzuki, Takefumi Yamaguchi, Yoshiyuki Satake, Kazuo Tsubota, Jun Shimazaki; Corneal higher order aberrations and visual acuity after deep anterior lamellar keratoplasty in treating keratoconus. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1333.
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© ARVO (1962-2015); The Authors (2016-present)
Deep anterior lamellar keratoplasty (DALK) is one of the standard surgical procedures to improve visual acuity in treating advanced keratoconus. However, postoperative visual acuity varies among patients undergoing DALK and the factors influencing it have been poorly understood. Recently, we have shown the association between corneal higher-order aberrations (HOAs) and visual acuity in various corneal diseases, such as infectious keratitis, post-endothelial keratoplasty and corneal stromal dystrophies. Here, we evaluated the association among the presence of Descemet’s membrane (DM) folds, corneal HOAs and visual acuity following DALK in treating keratoconus.
This retrospective study includes 35 eyes of 34 patients with keratoconus who underwent DALK from 2010 to 2016. Corneal HOAs of the anterior, posterior surfaces and the total cornea were analyzed by anterior segment optical coherence tomography (3D CAS-OCT SS-1000, TOMEY, Nagoya, Japan). We evaluated the correlations among the presence of DM folds, corneal HOAs and visual acuity at 12 months after DALK.
Mean logarithm of the minimal angle of resolution (log MAR) visual acuity significantly improved from 1.05±0.53 to 0.44±0.54 after 12months from DALK procedure(p<.0001). There was no significantly difference in postoperative logMAR between the eyes with and without DM folds (0.57±0.45 vs 0.30±0.47, p=0.16). The visual acuity at 12 months after DALK was significantly correlated with corneal HOAs of the anterior surface (R=0.555, p=0.002 and the total cornea (R=0.562, p=0.002), not with the posterior surface (R=0.307, p=0.105).
Postoperative corneal HOA, not DM folds is associated with worse visual acuity after DALK. Thus, in treating advanced keratoconus by DALK, to minimize corneal HOAs is important for postoperative patients’ vision although abnormal cornea with large amount of coma aberration due to keratoconus is removed by the surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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