Keratometric analysis of thin and ultrathin DSEK

Tsatos, Michael, Konstantopoulos, Aristides, Hossain, Parwez and Anderson, David F. (2012) Keratometric analysis of thin and ultrathin DSEK. Investigative Ophthalmology & Visual Science, 53 (14).

Abstract

Purpose: : Descemet stripping endothelial keratoplasty has been established as the treatment ofchoice in endothelial dysfunction. There remains a major controversy whether the difference between thinner and thicker grafts has a significant impact on visual outcome. Ouraim is to evaluate the influence of ultrathin and thin DSEK grafts on the optical performanceof the cornea post DSEK and determine whether there is a difference in the optical performance between thin and ultrathin graft lenticules Methods: : We studied two groups of patients one with regular donor thickness ( thin grafts131 µm or more) and one with ultrathin grafts (130 µm or less). All DSEK patients were assessed by means Pentacam HR rotating slit beam Scheimpflug imaging (Oculus, Wetzlar, Germany) and best corrected visual acuity (BCVA). Graft thickness post-operatively was measured by Visante OCT. 34 eyes of 32 patients were included in the keratometric evaluation. Results: : Mean age of the patients was 72yr (range 36-90), Median 75yr. Minimum F/U- 4m - Mean 13.3 (range 4-22), Median 11.5m. Oculus Pentacam HR >130 μm LOA mean ± SD 0.67 ± 0.37 Range 0.34 -1.52 HOA mean ± SD 0.13 ± 0.06 Range 0.07 -0.26 TA mean± SD 0.67 ± 0.37 Range 0.31 - 1.54 Oculus Pentacam HR <130 μm LOA mean ± SD 0.60 ± 0.15 Range 0.38 - 0.99 HOA mean ± SD 0.141± 0.03 Range 0.09 - 0.16 TA mean ± SD 0.64 ± 0.15 Range 0.37 - 1.00Low order, high order and total aberrations measured at 8mm did not correlate with graft or corneal thickness. Conclusions: : No significant difference was found when BCVA was compared between ultrathingrafts (<130μm) and grafts >130μm. Only patients with ultrathin grafts achievedBCVA of 0.2 or better. No significant correlation existed between donor lenticule, host corneal and total corneal thickness with BCVA and corneal aberrations. No significant difference was found in low and high\ order aberrations of the two groups but the total aberrations were significantly different between the ultrathin and the thin DSEK group.

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Contributors

Author: Parwez Hossain

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