Induced hyperopic shift seen up to 12 months after DSAEK

J Cataract Refract Surg. 2009;35(8);1473.

Descemet stripping automated endothelial keratoplasty was found to correlate with a significant hyperopic shift up to 12 months postop, a study showed.

"This is the first study to examine refractive stability specifically in patients selected for preoperative parameters leading to accurate preoperative manifest refraction," the study authors said in correspondence to the Journal of Cataract & Refractive Surgery. "In this study, the mean refractive shift after DSAEK was +0.99 D to +1.00 D and did not shift significantly between 6 months and 12 months."

The prospective study included 34 eyes that underwent DSAEK for Fuchs' endothelial dystrophy or pseudophakic bullous keratopathy. All eyes had relatively normal surface regularity and asymmetry indices, with preoperative visual acuity better than 20/100. Pre-cut corneal tissue was used in three cases.

A probability value of less than 0.05 was deemed statistically significant.

Preoperative mean spherical manifest refraction was –0.13 D. At 6 months, mean manifest refraction was +0.87 D. The hyperopic shift was statistically significant (P < .001).

Among 22 patients for whom 12-month data were available, mean preoperative manifest refraction was –0.02 D. These patients' mean manifest refraction at 12 months was +0.97 D. This hyperopic shift was also statistically significant (P < .001).

Manifest refraction did not shift appreciably between 6 months and 12 months postop.

"Current study is directed toward assessing the refractive shift on an individual graft-by-graft basis so refractive data can be incorporated into patient surgical planning on a case-by-case basis," the authors said.