Impact of graft thickness on visual acuity after Descemet's stripping endothelial keratoplasty

Download

Description/Abstract

Objective To evaluate the relationship, over time,
between central graft thickness and visual acuity following
Descemet’s stripping endothelial keratoplasty (DSEK).
Methods A retrospective analysis of 70 consecutive
cases of DSEK. All donor lenticules were dissected
manually. Serial postoperative measurements of central
graft and total corneal thicknesses were made using
anterior segment optical coherence tomography. Visual
acuity, refraction and patient demographics were
collected from case notes. The correlation between
central graft thickness and visual acuity at serial time
points was calculated.
Results The median age at surgery was 75 years
(lower quartile (LQ) 66, upper quartile (UQ) 83, range
36e90 years). Nineteen eyes were excluded from
statistical analysis, leaving 51 eyes of 46 patients
remaining. Last follow-up occurred a median of 12 months
postoperatively (LQ 6, UQ 23, range 4e38 months). The
median preoperative visual acuity was 0.71 logarithm of
the minimum angle of resolution (logMAR), improving to
0.34 logMAR postoperatively (p<0.001, n¼43). Median
graft thickness decreased from 209 mm at day 1 to
142 mm at last follow-up (p<0.001). No statistically
significant correlation was found between central total
corneal thickness and visual acuity at any time point.
Except for a single time point, no statistically significant
correlation was found between central graft thickness and
visual acuity.
Conclusion There is no clear association between central
graft, or total corneal, thickness and visual acuity following
DSEK.