title: Corneal Astigmatism Stability in Descemet Membrane Endothelial Keratoplasty for Fuchs Corneal Dystrophy.
abstract: OBJECTIVE
  To calculate the magnitude and angle of the shift in corneal astigmatism associated with Descemet membrane endothelial keratoplasty (DMEK) surgery to determine the feasibility of concurrent astigmatism correction at the time of DMEK triple procedures.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Forty-seven eyes that previously underwent the DMEK procedure for Fuchs endothelial corneal dystrophy and that had more than 1.0 diopter (D) of front corneal astigmatism preoperatively were identified. All DMEK surgeries used a clear corneal temporal incision of 3.2 mm. Surgically induced astigmatism (SIA) was evaluated 6 months postsurgery with vector analysis using Scheimpflug image reading.
  
  
  RESULTS
  We did not find a difference between pre- and postoperative magnitude of front astigmatism (P = 0.88; paired t test). The magnitude of the SIA front surface was 0.77 ± 0.63 D (range, 0.10-3.14 D). The centroid vector of the SIA front surface was 0.14 at 89.3°. A hyperopic corneal power shift was noted in both the front surface by 0.26 ± 0.74 D (range, 0.45-3.05 D) (P = 0.018; paired t test) and back surface by 0.56 ± 0.55 D (range, 0.25-2.40 D) (P < 0.01; paired t test).
  
  
  CONCLUSIONS
  DMEK surgery induces minimal amounts of corneal astigmatism that is a with-the-rule shift associated with a temporal clear corneal incision. The stability of these data from preop to postop supports the plausibility of incorporating astigmatism correction with the cautious use of toric intraocular lenses for patients with Fuchs corneal dystrophy and cataract.
authors.affiliation: *Cornea Service, Devers Eye Institute, Portland, OR; †Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan; and ‡Lions VisionGift, Portland, OR.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.forename: P James
authors.initials: PJ
authors.lastname: Sanchez
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Mayko
authors.forename: Michael D
authors.initials: MD
authors.lastname: Straiko
authors.forename: Mark A
authors.initials: MA
authors.lastname: Terry
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000503:physiopathology*; D003315:Cornea / Q000503:physiopathology*; D019781:Corneal Topography; D003886:Descemet Membrane; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology