This article is more than 5 years old. Information may no longer be current.
Hyperopic shift after DSAEK attributed to changes in posterior corneal curvature
Ophthalmology. 2009;116(9):1651-1655.
Click Here to Manage Email Alerts
A hyperopic shift identified after Descemet's stripping automated endothelial keratoplasty was attributed to changes in the posterior corneal curvature, a study showed.
"The difference in thickness between center and periphery of the DSAEK graft induces a change in posterior corneal curvature, resulting in a hyperopic shift that decreases with time and is negligible for spectacle correction," the study authors said. "However, when performing a triple procedure, intraocular lens selection should take into account the refractive change induced by DSAEK."
The prospective study included 34 eyes of 29 patients with Fuchs' endothelial dystrophy or pseudophakic bullous keratopathy.
All eyes underwent DSAEK. Adjunctive phacoemulsification with posterior chamber IOL implantation was performed in seven eyes with cataracts. The Pentacam Scheimpflug camera (Oculus) was used to evaluate eyes at 1, 3 and 12 months postoperatively. Corneal graft thickness was calculated at one central location, four peripheral locations and four mid-peripheral locations.
Primary outcome measures were radius of posterior corneal curvature, manifest refraction and corneal graft thickness.
Mean posterior corneal curvature was 6.5 mm preoperatively, 5.52 mm at 1 month, 5.83 mm at 3 months and 5.92 mm at 12 months. Grafts were markedly thicker in the periphery and mid-periphery than in the center at all follow-up points. Graft thickening decreased appreciably in all locations with time.
Average spherical equivalent was -0.31 D before surgery, 1.03 D at 1 month, 0.61 D at 3 months and 0.31 D at 12 months, the authors said.