title: Corneal haze determined by confocal microscopy 2 years after Descemet stripping with endothelial keratoplasty for Fuchs corneal dystrophy.
abstract: OBJECTIVE
  To quantify corneal light scatter and its relationship to vision after Descemet stripping with endothelial keratoplasty (DSEK).
  
  
  METHODS
  Eyes with Fuchs corneal dystrophy were examined before and 1, 3, 6, 12, and 24 months after DSEK. Outcome measures were high- and low-contrast visual acuity, contrast sensitivity, and forward light scatter. Corneal reflectivity (backscatter), expressed in scatter units (SU), was quantified using in vivo confocal microscopy.
  
  
  RESULTS
  Comparing 49 study eyes with 35 normal eyes, the mean (SD) corneal subepithelial layer was more reflective than normal before (2325 [613] vs 1208 [287] SU, P<.001) and through 24 months after DSEK (1760 [432] SU, P<.001). Interface reflectivity remained higher than in normal stroma through 24 months (1228 [287] vs 827 [188] SU, P<.001). At 1 year, forward light scatter correlated with subepithelial reflectivity (r=0.28, P=.01) but not interface reflectivity. Recipient age was correlated with improvement in subepithelial reflectivity at 12 months (r=–0.41, P=.01, 34 eyes) and 24 months (r=–0.36, P=.02, 26 eyes) after DSEK, and the improvement of subepithelial haze in eyes of participants aged 62 years or younger was correlated with improvement in forward light scatter at 12 months (r=0.52, P=.008) and 24 months (r=0.62, P=.004).
  
  
  CONCLUSIONS
  In Fuchs corneal dystrophy, the corneal subepithelial region is a more important source of forward light scatter than the DSEK interface. Subepithelial haze improves more in younger patients and is associated with improvement in forward light scatter.
  
  
  CONCLUSIONS
  Visual function after DSEK is affected by residual haze in the anterior host cornea more so than the surgical interface. Haze, which likely is experienced as glare disability, improves after surgical intervention but improves more in younger patients.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA. baratz.keith@mayo.edu
authors.forename: Keith H
authors.initials: KH
authors.lastname: Baratz
authors.forename: Jay W
authors.initials: JW
authors.lastname: McLaren
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Maguire
authors.forename: Sanjay V
authors.initials: SV
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology; D003318:Corneal Opacity / Q000175:diagnosis* / Q000503:physiopathology; D057111:Descemet Stripping Endothelial Keratoplasty; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008027:Light; D018613:Microscopy, Confocal; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012542:Scattering, Radiation; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult