title: Graft-Recipient Collagen Lamellar Axis Discrepancy Is Compatible With Excellent Visual Acuity After Descemet Stripping Automated Endothelial Keratoplasty.
abstract: OBJECTIVE
  To evaluate whether a discrepancy between the orientation of graft and recipient collagen lamellae can significantly limit the visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK).
  
  
  METHODS
  A multicenter cohort study of eyes that underwent DSAEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy at Villa Serena-Villa Igea private Hospitals (Forlì, Italy) and at Santa Maria Nuova public hospital (Reggio Emilia, Italy), which were scheduled for a postoperative examination between July and September 2014. We have included eyes with a distance-corrected visual acuity of 8/10 or better, no ocular comorbidities, and a clear cornea. The main outcome measure was graft-recipient axis discrepancy of lamellar orientation around the visual axis as assessed by polarimetric interferometry.
  
  
  RESULTS
  Twelve eyes were included in this study. Eight eyes had a spectacle-corrected distance visual acuity of 8/10, 3 eyes had 9/10, and 1 eye had 10/10. In 8/12 (66.7%) eyes, 2 discernible axes of collagen lamellar orientation were identified and were all 30 degrees or more apart (range 30-90). In 2 eyes, only 1 axis was identified and in another 2 eyes, 2 axes 20 and 17 degrees apart were identified. The eye with 10/10 visual acuity presented a discrepancy of 17 degrees between lamellar axes.
  
  
  CONCLUSIONS
  A discrepancy between the lamellar orientation of the graft and the recipient is compatible with excellent visual acuity after DSAEK.
authors.affiliation: *Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Department of Ophthalmology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy; §Phronema srl, Taranto, Italy; ¶Department of Ophthalmology, "Villa Igea" Hospital, Forlì, Italy; and ‖Istituto internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Nahum
authors.forename: Alfonso
authors.initials: A
authors.lastname: Iovieno
authors.forename: Eugenio
authors.initials: E
authors.lastname: Lipari
authors.forename: Luigi
authors.initials: L
authors.lastname: Fonatana
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003094:Collagen / Q000737:chemistry*; D057111:Descemet Stripping Endothelial Keratoplasty; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007368:Interferometry; D008875:Middle Aged; D000072458:Orientation, Spatial; D012189:Retrospective Studies; D066027:Transplant Recipients; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D003094:Collagen