Visual performance with wave aberration correction after penetrating, deep anterior lamellar, or endothelial keratoplasty.
OBJECTIVE
To investigate the contribution ocular aberrations have on visual performance by quantifying improvements in best-corrected visual acuity (VA) and contrast sensitivity (CS) obtained with higher-order aberration (HOA) correction after penetrating (PK), deep anterior lamellar (DALK), or Descemet's stripping automated endothelial keratoplasty (DSAEK).


METHODS
Sixteen eyes were evaluated from 14 subjects who underwent PK (n = 5), DALK (n = 6), or DSAEK (n = 5) greater than 1 year prior to study enrollment. Ocular aberrations were measured and an adaptive optics system was used to correct ocular lower-order aberration (LOA) and HOA. VA and CS were measured for each subject with LOA or full-aberration correction. CS was measured at each of three spatial frequencies: 4, 8, and 12 cycles/deg.


RESULTS
All keratoplasty groups had more aberration than that of a normal myopic population and experienced significant VA gains with full-aberration correction (P < 0.0013). PK subjects had better VA than that of DSAEK subjects with LOA correction (logMAR VA 0.03 ± 0.05 vs. 0.25 ± 0.05; P = 0.0870). After HOA correction this trend persisted (P = 0.1734). DSAEK subjects also experienced less VA benefit from full-aberration correction than that of PK and DALK subjects. All keratoplasty groups demonstrated similar CS benefits from full-aberration correction despite differing higher-order root-mean-square magnitudes.


CONCLUSIONS
PK eyes had better logMAR VA than that of DSAEK eyes with LOA correction, whereas DALK eyes performed intermediate between the two. When full correction was applied, the same trend persisted. The findings suggest that factors other than aberration contribute to decrements in VA with DSAEK compared with PK.
David and Ilene Flaum Eye Institute, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Seth M
SM
Pantanelli
Ramkumar
R
Sabesan
Steven S T
SS
Ching
Geunyoung
G
Yoon
Holly B
HB
Hindman
D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology*; D057108:Corneal Wavefront Aberration / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000503:physiopathology / Q000637:transplantation; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*