Optical quality of the cornea after Descemet membrane endothelial keratoplasty.
OBJECTIVE
To evaluate corneal higher-order aberrations (HOAs) and backscattered light before and after Descemet membrane endothelial keratoplasty (DMEK) and their correlation with visual outcome.


METHODS
Retrospective study.


METHODS
In a total of 118 consecutive eyes of 118 patients who underwent uneventful DMEK for Fuchs endothelial dystrophy at a tertiary referral center, best spectacle-corrected visual acuity (BSCVA), corneal HOAs, and backscattered light were evaluated preoperatively and at 6 months postoperatively. Outcome data were compared to an age-matched control group with uncomplicated eyes (n = 27).


RESULTS
Compared to the control group, Fuchs endothelial dystrophy eyes, before as well as 6 months after DMEK, showed higher values of anterior and posterior HOAs and backscattered light (P < .033). Postoperative anterior HOAs and backscattered light (0-2 mm) were associated with lower 6-month BSCVA (positively related with logMAR BSCVA) (P ≤ .020). Anterior corneal HOAs did not change from preoperative to 6 months after DMEK (P = .649), while total posterior HOAs (RMS third to sixth Zernike order) and haze decreased (P < .001).


CONCLUSIONS
Anterior and posterior corneal HOAs, as well as backscattered light from the cornea, were elevated in eyes suffering from Fuchs endothelial dystrophy and remained higher throughout 6 months after DMEK. If present, anterior surface irregularities and anterior corneal haze may be the most important limiting factors in visual rehabilitation after DMEK.
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Melles Cornea Clinic, Rotterdam, Netherlands.
Korine
K
van Dijk
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Melles Cornea Clinic, Rotterdam, Netherlands; Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Germany.
Konstantinos
K
Droutsas
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Amnitrans EyeBank, Rotterdam, Netherlands.
Jingzhen
J
Hou
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Amnitrans EyeBank, Rotterdam, Netherlands.
Sassan
S
Sangsari
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Melles Cornea Clinic, Rotterdam, Netherlands.
Vasilios S
VS
Liarakos
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Melles Cornea Clinic, Rotterdam, Netherlands; Amnitrans EyeBank, Rotterdam, Netherlands. Electronic address: research@niios.com.
Gerrit R J
GR
Melles
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000503:physiopathology*; D063171:Corneal Pachymetry; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000175:diagnosis / Q000503:physiopathology*; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012542:Scattering, Radiation; D014792:Visual Acuity / Q000502:physiology