Graft thickness correlates with folds and higher-order aberrations after DSEK

Am J Ophthalmol. 2011;152(6):910-916.

Pseudophakic eyes that underwent Descemet stripping endothelial keratoplasty for Fuchs' dystrophy had more higher-order aberrations than pseudophakic eyes with untreated corneas, a study found.

"Whole-eye [higher-order aberrations] are higher after DSEK compared to untreated corneas," the study authors said. "Thicker grafts were associated with more graft folds and with increased [higher-order aberrations], but the average effect of the [higher-order aberrations] on visual acuity was small."

The prospective study included 46 pseudophakic eyes of 40 subjects who underwent DSEK for Fuchs' dystrophy; 36 eyes of 29 subjects were examined at 12 months, and 27 eyes of 24 subjects were examined at 24 months. Mean patient age was 67 years.

A control group for higher-order aberrations included 25 pseudophakic eyes of 17 subjects. Mean subject age was 70 years. A second control group for graft folds comprised 36 untreated eyes of 18 subjects. Mean subject age was 43 years.

Pseudophakic eyes received an AcrySof SA60AT spherical IOL (Alcon). Shack-Hartmann aberrometry was used to measure higher-order aberrations. Confocal microscopy was used to measure graft folds and central graft thickness.

At 24 months, total higher-order aberrations were 0.28 ?m in the DSEK group and 0.16 ?m in the first control group; the between-group difference was statistically significant (P < .001). DSEK eyes had significantly greater coma than controls (P = .04). Total higher-order aberrations correlated significantly with graft thickness at 24 months (P < .001). BCVA correlated significantly with total higher-order aberrations (P = .01), trefoil (P < .001) and quadrafoil (P < .001) at 24 months.

Data showed no correlation between BCVA and graft thickness at 12 months or 24 months, the authors said.