Poor visual acuity after big bubble DALK linked to elongated posterior segment

Issue: March 25, 2016

Poor visual outcomes after big bubble deep anterior lamellar keratoplasty may be attributable to large vitreous length, higher-order aberrations and surgical interface haze, according to a study.

“Our results reflect the fact that differences in postoperative visual acuity are independent of corneal features and show that the main factor that contributed to decreases in [best corrected visual acuity] was an elongated posterior segment,” the study authors said.

The prospective study included 36 eyes of 36 patients who underwent big bubble DALK.

Investigators assessed the impact of recipient, donor and postoperative variables on postoperative BCVA and contrast sensitivity. Mean follow-up was 24.6 months.

Mean postoperative logMAR BCVA was 0.17. Postoperative BCVA was 20/25 or better in 14 eyes (38.9%), 20/30 in 15 eyes (41.7%), 20/40 in six eyes (16.6%) and 20/50 in one eye (2.8%).

A significant association was observed between preoperative vitreous length and postoperative BCVA (P = .03).

Scotopic contrast sensitivity and photopic contrast sensitivity were significantly affected by the donor-recipient interface (P = .04 and P = .02, respectively).

There was a significantly inverse relationship between root mean square of tetrafoil and scotopic contrast sensitivity (P = .01) and photopic contrast sensitivity (P = .04).

Postoperative visual acuity and contrast sensitivity did not have a significant relationship with recipient age, severity of keratoconus, donor-related variables, recipient trephination size, and graft or recipient bed thickness. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Feizi S, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2015.11.018.