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Evaluation of factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To elucidate the factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods

We reviewed consecutive patients who underwent primary DSAEK for corneal endothelial dysfunction at Inouye Eye Hospital from January 2010 through January 2015 and who had a follow-up of at least 6 months. Fifty-four eyes of 49 patients (24 men and 25 women) were enrolled; the mean age was 72.5 ± 8.7 years. Medical charts were retrospectively examined for best spectacle-corrected visual acuity (BSCVA), intraocular pressure, keratometric value, keratometric cylinder, grade of preoperative corneal edema, preoperative graft thickness, and endothelial cell density (ECD) before and at 1, 3, 6, 12, and 24 months after surgery. A multiple regression analysis was used to evaluate the factors associated with BSCVA at 3, 6 months, and 1 year after surgery. Explanatory variables included age, sex, preoperative factors (BSCVA, degree of corneal edema, donor ECD, and graft thickness), and factors at each time point (keratometric value, keratometric cylinder, and intraocular pressure).

Results

The mean logarithms of the minimum angle of resolution (logMAR) BSCVA preoperatively and at 1, 3, 6, and 12 months after surgery were 1.03 ± 0.49, 0.42 ± 0.26, 0.29 ± 0.21, 0.24 ± 0.20, and 0.22 ± 0.20, respectively. Multiple regression analysis showed that preoperative BSCVA alone was significantly associated with BSCVA at 3, 6, and 12 months.

Conclusion

A better preoperative BSCVA was associated with a better BSCVA after DSAEK, which suggests that DSAEK should be considered earlier than stromal changes such as subepithelial fibrosis occurrence.

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References

  1. Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM. Descemet’s stripping endothelial keratoplasty: safety and outcomes: a report by the American Academy of Ophthalmology. Ophthalmology. 2009;116:1818–30.

    Article  PubMed  Google Scholar 

  2. Anshu A, Price MO, Tan DT, Price FW Jr. Endothelial keratoplasty: a revolution in evolution. Surv Ophthalmol. 2012;57:236–52.

    Article  PubMed  Google Scholar 

  3. Price MO, Giebel AW, Fairchild KM, Price FW Jr. Descemet’s membrane endothelial keratoplasty: prospective multicenter study of visual and refractive outcomes and endothelial survival. Ophthalmology. 2009;116:2361–8.

    Article  PubMed  Google Scholar 

  4. Tourtas T, Laaser K, Bachmann BO, Cursiefe C, Kruse FE. Descemet membrane endothelial keratoplasty versus Descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2012;153:1082–90.

    Article  PubMed  Google Scholar 

  5. Hamzaoglu EC, Straiko MD, Mayko ZM, Sáles CS, Terry MA. The first 100 eyes of standardized Descemet stripping automated endothelial keratoplasty versus standardized Descemet membrane endothelial keratoplasty. Ophthalmology. 2015;122:2193–9.

    Article  PubMed  Google Scholar 

  6. Goldich Y, Showail M, Avni-Zauberman N, Perez M, Ulate R, Elbaz U, et al. Contralateral eye comparison of Descemet membrane endothelial keratoplasty and Descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2015;159:155–9.

    Article  PubMed  Google Scholar 

  7. Patel SV, Baratz KH, Hodge DO, Maguire LJ, McLaren JW. The effect of corneal light scatter on vision after Descemet stripping with endothelial keratoplasty. Arch Ophthalmol. 2009;127:153–60.

    Article  PubMed  Google Scholar 

  8. van der Meulen IJ, Patel SV, Lapid-Gortzak R, Niewendaal CP, McLaren JW, van den Berg TJ. Quality of vision in patients with Fuchs endothelial dystrophy and after Descemet stripping endothelial keratoplasty. Arch Ophthalmol. 2011;129:1537–42.

    Article  PubMed  Google Scholar 

  9. Ang M, Lim F, Htoon HM, Tan D, Mehta JS. Visual acuity and contrast sensitivity following Descemet stripping automated endothelial keratoplasty. Br J Ophthalmol. 2016;100:307–11.

    Article  PubMed  Google Scholar 

  10. Neff KD, Biber JM, Holland EJ. Comparison of central corneal graft thickness to visual acuity outcomes in endothelial keratoplasty. Cornea. 2011;30:388–91.

    Article  PubMed  Google Scholar 

  11. Dickman MM, Cheng YY, Berendschot TT, van den Biggelaar FJ, Nuijts RM. Effects of graft thickness and asymmetry on visual gain and aberrations after Descemet stripping automated endothelial keratoplasty. JAMA Ophthalmol. 2013;131:737–44.

    Article  PubMed  Google Scholar 

  12. Morishige N, Chikama T, Yamada N, Takahashi N, Morita Y, Nishida T, et al. Effect of preoperative duration of stromal edema in bullous keratopathy on early visual acuity after endothelial keratoplasty. J Cataract Refract Surg. 2012;38:303–8.

    Article  PubMed  Google Scholar 

  13. Muftuoglu O, Prasher P, Bowman RW, McCulley JP, Mootha VV. Corneal higher-order aberrations after Descemet’s stripping automated endothelial keratoplasty. Ophthalmology. 2010;117:878–84.

    Article  PubMed  Google Scholar 

  14. Seery LS, Nau CB, McLaren JW, Baratz KH, Patel SV. Graft thickness, graft folds, and aberrations after Descemet stripping endothelial keratoplasty for Fuchs dystrophy. Am J Ophthalmol. 2011;152:910–6.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hindman HB, Huxlin KR, Pantanelli SM, Callan CL, Sabesan R, Ching SS, et al. Post-DSAEK optical changes: a comprehensive prospective analysis on the role of ocular wavefront aberrations, haze, and corneal thickness. Cornea. 2013;32:1567–77.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kamiya K, Asato H, Shimizu K, Kobashi H, Igarashi A. Effect of intraocular forward scattering and corneal higher-order aberrations on visual acuity after Descemet’s stripping automated endothelial keratoplasty. PLoS One. 2015;10:e0131110.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kobayashi A, Yokogawa H, Sugiyama K. Descemet stripping with automated endothelial keratoplasty for bullous keratopathies secondary to argon laser iridotomy: preliminary results and usefulness of double-glide donor insertion technique. Cornea. 2008;27(Suppl 1):S62–9.

    Article  PubMed  Google Scholar 

  18. Kobayashi A, Yokogawa H, Sugiyama K. Non-Descemet stripping automated endothelial keratoplasty for endothelial dysfunction secondary to argon laser iridotomy. Am J Ophthalmol. 2008;146:543–9.

    Article  PubMed  Google Scholar 

  19. Ahmed KA, McLaren JW, Baratz KH, Maguire LJ, Kettleson KM, Patel SV. Host and graft thickness after Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy. Am J Ophthalmol. 2010;150:490–7.

    Article  PubMed  Google Scholar 

  20. Terry MA, Straiko MD, Goshe JM, Li JY, Davis-Boozer D. Descemet’s stripping automated endothelial keratoplasty: the tenuous relationship between donor thickness and postoperative vision. Ophthalmology. 2012;119:1988–96.

    Article  PubMed  Google Scholar 

  21. Phillips PM, Phillips LJ, Maloney CM. Preoperative graft thickness measurements do not influence final BSCVA or speed of vision recovery after Descemet stripping automated endothelial keratoplasty. Cornea. 2013;32:1423–7.

    Article  PubMed  Google Scholar 

  22. Woodward MA, Raoof-Daneshvar D, Mian S, Shtein RM. Relationship of visual acuity and lamellar thickness in Descemet stripping automated endothelial keratoplasty. Cornea. 2013;32:e69–73.

    Article  PubMed  Google Scholar 

  23. Shimazaki J, Amano S, Uno T, Maeda N, Yokoi N, Japan Bullous Keratopathy Study Group. National survey on bullous keratopathy in Japan. Cornea. 2007;26:274–8.

    Article  PubMed  Google Scholar 

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Correspondence to Shiro Amano.

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Conflicts of interest

S. Amano, Grants (Alcon, AMO, HOYA, Otsuka Pharmaceutical, Santen Pharmaceutical, Senju Pharmaceutical), Lecture fees (Alcon, AMO, HOYA, Otsuka Pharmaceutical, Santen Pharmaceutical, Senju Pharmaceutical); A. Setogawa, None; K. Inoue, None.

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Amano, S., Setogawa, A. & Inoue, K. Evaluation of factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty. Jpn J Ophthalmol 61, 137–141 (2017). https://doi.org/10.1007/s10384-016-0491-8

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  • DOI: https://doi.org/10.1007/s10384-016-0491-8

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