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Determinants of visual quality after endothelial keratoplasty

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
0039-6257
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
602602f5-f986-42db-b0e0-dfef3205cf80
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
602602f5-f986-42db-b0e0-dfef3205cf80

Trunbull, Andrew M.J., Tsatos, Michael, Hossain, Parwez and Anderson, David (2016) Determinants of visual quality after endothelial keratoplasty. Survey of Ophthalmology, 61 (3), 257-271. (doi:10.1016/j.survophthal.2015.12.006). (PMID:26708363)

Record type: Article

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
1-s2.0-S0039625715300096-main.pdf__tid=7fc55318-bebd-11e5-bc1a-00000aab0f01&acdnat=1453215860_aba50e048ef7e527b275a19a06c49ac5 - Accepted Manuscript
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More information

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: https://eprints.soton.ac.uk/id/eprint/385392
ISSN: 0039-6257
PURE UUID: d5873192-2a0b-4fea-ab17-bd395559bfc1
ORCID for Parwez Hossain: ORCID iD orcid.org/0000-0002-3131-2395

Catalogue record

Date deposited: 19 Jan 2016 15:05
Last modified: 03 Dec 2019 01:47

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