Host and graft thickness after Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy.

Abstract

PURPOSE:

To determine relationships between vision, forward scatter, and total corneal and graft thicknesses after Descemet stripping endothelial keratoplasty (DSEK).

DESIGN:

Prospective, cohort study.

METHODS:

Forty-four eyes with Fuchs endothelial dystrophy were examined before and at 1, 3, 6, and 12 months after DSEK; all eyes were pseudophakic after surgery. Central total corneal and graft thicknesses were measured using confocal microscopy. Best-corrected high-contrast visual acuity (BCVA) was measured using the electronic Early Treatment Diabetic Retinopathy Study protocol, and forward light scatter was measured using a straylight meter.

RESULTS:

Total corneal thickness was 610 ± 50 μm (mean ± standard deviation) before DSEK, increased to 680 ± 74 μm by 1 month after DSEK (P < .001), and stabilized at 660 ± 68 μm by 3 months after DSEK (P = .03 vs 1 month). Graft thickness was 170 ± 57 μm at 1 month, decreased to 157 ± 49 μm by 3 months (P = .004), and then remained stable through 12 months (156 ± 51 μm; P = .99 vs 3 months). BCVA was 0.44 ± 0.21 logarithm of the minimal angle of resolution (logMAR) units (Snellen equivalent, 20/55) before DSEK, improved to 0.26 ± 0.20 logMAR units (Snellen equivalent, 20/36) by 3 months (P < .001), and improved to 0.16 ± 0.16 logMAR units (Snellen equivalent, 20/29) at 12 months (P < .001 vs 3 months). BCVA and forward light scatter did not correlate with corneal or graft thickness after DSEK.

CONCLUSIONS:

Stromal edema resolves by 3 months after DSEK for Fuchs dystrophy, whereas visual acuity continues to improve through 12 months. Thicker corneas and grafts are not associated with worse visual acuity or increased forward scatter.

• Authors: Kamran A Ahmed, Jay W McLaren, Keith H Baratz, Leo J Maguire, Katrina M Kittleson, Sanjay V Patel
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 150 Issue 4 Pg. 490-497.e2 (Oct 2010) ISSN: 1879-1891 [Electronic] United States
• PMID: 20688317 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Anthropometry
• Body Weights and Measures
• Cohort Studies
• Cornea (pathology)
• Descemet Stripping Endothelial Keratoplasty
• Endothelium, Corneal (pathology, transplantation)
• Follow-Up Studies
• Fuchs' Endothelial Dystrophy (surgery)
• Humans
• Microscopy, Confocal
• Middle Aged
• Organ Transplantation
• Prospective Studies
• Visual Acuity (physiology)