Corneal profile analysis after Descemet stripping endothelial keratoplasty and its relationship to postoperative hyperopic shift
Accepted 27 September 2007.
Purpose
To evaluate changes in the corneal profile after Descemet stripping endothelial keratoplasty (DSEK) using anterior segment optical coherence tomography (AS-OCT) analysis and to describe its relationship to a dynamic postoperative hyperopic shift.
Setting
John A. Moran Eye Center, University of Utah, Salt Lake City, USA.
Methods
In this retrospective observational study, 9 eyes had DSEK and were followed with manifest refractions and AS-OCT analysis. To assess changes in the thickness of the cornea, measurements for each AS-OCT image were taken at the vertex of the cornea, at 1.5 mm on each side of the vertex, and at the distal edges of the graft.
Results
Patients were followed for a mean of 134 days (range 46 to 228 days). Monthly Graft thinning rates were 5.2 μm per month at the vertex, 7.9 μm per month 1.5 mm from the vertex, and 26 μm per month at the edges, with the edges thinning significantly faster than the cornea vertex (P = .0024) and the points on either side of the 3.0 mm visual axis (P = .0018). The mean spherical equivalent (SE) showed an initial hyperopic shift that decreased over the ensuing 100 to 200 days postoperatively. The mean monthly postoperative SE change was −0.25 diopter (D) with a mean preoperative to postoperative SE change of +1.26 D.
Conclusions
The donor graft underwent changes after DSEK, which may account for the induced hyperopia and its diminishment over time via changes in the posterior corneal curvature. Results suggest that intraocular lenses be targeted to −1.00 to −1.25 D of myopia for combined DSEK and cataract procedures.
From the John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
Corresponding author: Majid Moshirfar, MD, John A. Moran Eye Center, 6360 South 3000 East, Suite 200, Salt Lake City, Utah 84121, USA.
No author has a financial or proprietary interest in any material or method mentioned.
Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Diego, California, USA, April 2007.
Supported in part by a grant to the Department of Ophthalmology at the University of Utah, Salt Lake City, Utah, USA, and an unrestricted educational grant from Allergan Inc., Irvine, California, USA.
ABSTRACT