Comparison of Corneal Surface Higher-Order Aberrations After Endothelial Keratoplasty, Femtosecond Laser–Assisted Keratoplasty, and Conventional Penetrating Keratoplasty

Chamberlain, Winston; Omid, N.; Lin, Amy; Farid, Marjan; Gaster, Ronald N.; Steinert, Roger F.

doi:10.1097/ico.0b013e3182151df2

Cited by 40 publications

(30 citation statements)

References 22 publications

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“…corneal incisions) have a tangible effect on the anterior cornea. 21 Whole-eye HOAs were found to be higher post-DSEK than in corneas that had undergone non-wavefront guided LASIK surgery. 20 This has generated M A N U S C R I P T…”

Section: Anterior Cornea and Hoasmentioning

confidence: 99%

“…Theories include a more regular posterior graft surface with greater thickness uniformity , 31,77,112 thinner grafts with a better match in curvature, and improved parallelism between the graft and recipient and improved optical compensation by the posterior cornea. 139 Posterior corneal HOAs are increased after all forms of EK compared with normal controls, 21,54,84,108,137 and posterior corneal HOAs after DSAEK seem to be comparable to or greater than post-PKP. 21,108 It has been suggested that the posterior corneal surface is the source of increased whole-eye HOAs after DSEK compared with normal eyes or eyes post-PKP.…”

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

“…139 Posterior corneal HOAs are increased after all forms of EK compared with normal controls, 21,54,84,108,137 and posterior corneal HOAs after DSAEK seem to be comparable to or greater than post-PKP. 21,108 It has been suggested that the posterior corneal surface is the source of increased whole-eye HOAs after DSEK compared with normal eyes or eyes post-PKP. 54,95 This may be secondary to graft decentration, differences in curvature between the recipient and the graft, or uneven graft thickness from asymmetric trephination.…”

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

“…21 While all forms of keratoplasty had increased posterior corneal HOAs compared with normal controls, femtosecond laser-assisted keratoplasty (FLAK) resulted in the least, with the authors hypothesising that FLAK more closely replicates the natural posterior corneal curvature than DSAEK or PKP.…”

Section: Posterior Corneal Compensation Parallelism and Hoasmentioning

confidence: 99%

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Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.

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Section: Anterior Cornea and Hoasmentioning

confidence: 99%

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

Section: Posterior Corneal Compensation Parallelism and Hoasmentioning

confidence: 99%

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Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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“…Despite increasing surgical experience and technical standardization , overall visual outcome following Descemet-stripping automated endothelial keratoplasty (DSAEK) is often lower than following penetrating keratoplasty (PK) (Heinzelmann et al 2011;Chamberlain et al 2012). Therefore, we looked for a measurable correlate regarding the limited visual potential in DSAEK.…”

Section: Introductionmentioning

confidence: 99%

Correlation between visual acuity and interface reflectivity measured by pentacam following DSAEK

Heinzelmann¹,

Böhringer²,

Maier³

et al. 2013

Acta Ophthalmologica

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. Purpose: Descemet‐stripping automated endothelial keratoplasty (DSAEK) is an advanced method of lamellar endothelial keratoplasty. In comparison with penetrating keratoplasty, visual rehabilitation seems to be faster. Final visual outcome of DSAEK, however, seems to be limited, especially in comparison with Descemet membrane endothelial keratoplasty (DMEK). DSAEK cases without graft failure often do not show any definite correlate for the reduced optical performance. In this study, we tried to correlate visual acuity following DSAEK with interface reflectivity as measured by a rotating Scheimpflug system. Methods: We examined 14 eyes of 13 patients with the pentacam for 2–11 months following DSAEK. Reflectivity of the interface region in the centre of the optical axis as well as central corneal thickness was determined. Statistical correlation between interface reflectivity and best spectacle‐corrected visual acuity, central corneal thickness and follow‐up time was drawn (multifactorial linear regression analysis). Results: Statistically significant correlation between interface reflectivity and BSCVA as well as follow‐up time was found. Reflectivity was highest in regions of interface (metal) particles. There was no statistically significant correlation between interface reflectivity and central corneal thickness. Conclusion: We present a measurable correlate for reduced visual outcome following DSAEK despite a clear graft. Inverse correlation between interface reflectivity and best spectacle‐corrected visual acuity (BSCVA) indicates that irregularities or scarring in the interface region may influence the optical quality following DSAEK.

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Effects of Graft Thickness and Asymmetry on Visual Gain and Aberrations After Descemet Stripping Automated Endothelial Keratoplasty

Dickman

Cheng²,

Berendschot³

et al. 2013

JAMA Ophthalmol

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Importance: Understanding the contribution of graft thickness and asymmetry to visual gain and posterior corneal (PC) higher-order aberrations (HOAs) may assist optimizing visual outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK).Objective: To investigate the effects of graft thickness and asymmetry on visual gain and aberrations after DSAEK.Design: Retrospective analysis of an interventional case series of eyes undergoing DSAEK. Visual gain was defined as the difference between preoperative and 6-month postoperative best-corrected visual acuity in logMAR equivalents. Graft thickness was measured by anterior-segment optical coherence tomography. Corneal topography and HOAs were measured by Scheimpflug imaging. Raw posterior corneal (PC) elevation data were exported and fitted against a bestfitted sphere, providing a measure of donor lenticule asymmetry. Correlation analysis was performed among visual gain, graft thickness, graft asymmetry, and PC HOAs.

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Comparison of Corneal Surface Higher-Order Aberrations After Endothelial Keratoplasty, Femtosecond Laser–Assisted Keratoplasty, and Conventional Penetrating Keratoplasty

Cited by 40 publications

References 22 publications

Determinants of visual quality after endothelial keratoplasty

Determinants of visual quality after endothelial keratoplasty

Correlation between visual acuity and interface reflectivity measured by pentacam following DSAEK

Effects of Graft Thickness and Asymmetry on Visual Gain and Aberrations After Descemet Stripping Automated Endothelial Keratoplasty

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