Determinants of visual quality after endothelial keratoplasty
Determinants of visual quality after endothelial keratoplasty
Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.
endothelial keratoplasty / DSEK / DSAEK / DMEK, descemet membrane, visual acuity, visual quality, optics, aberrations, cornea
257-271
Trunbull, Andrew M.J.
af8a5cc8-cf67-4f61-9177-354794f0a97c
Tsatos, Michael
49820135-c443-4bb0-aa7c-f602ea3207af
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Anderson, David
4cf6cabc-081a-48b5-98bf-5fabe7d184d5
May 2016
Trunbull, Andrew M.J.
af8a5cc8-cf67-4f61-9177-354794f0a97c
Tsatos, Michael
49820135-c443-4bb0-aa7c-f602ea3207af
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Anderson, David
4cf6cabc-081a-48b5-98bf-5fabe7d184d5
Abstract
Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.
Other
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- Accepted Manuscript
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Accepted/In Press date: 15 December 2015
e-pub ahead of print date: 18 December 2015
Published date: May 2016
Keywords:
endothelial keratoplasty / DSEK / DSAEK / DMEK, descemet membrane, visual acuity, visual quality, optics, aberrations, cornea
Organisations:
Clinical & Experimental Sciences
Identifiers
Local EPrints ID: 385392
URI: http://eprints.soton.ac.uk/id/eprint/385392
ISSN: 0039-6257
PURE UUID: d5873192-2a0b-4fea-ab17-bd395559bfc1
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Date deposited: 19 Jan 2016 15:05
Last modified: 15 Mar 2024 03:24
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Contributors
Author:
Andrew M.J. Trunbull
Author:
Michael Tsatos
Author:
David Anderson
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