Pentacam Assessment of Posterior Lamellar Grafts to Explain Hyperopization after Descemet's Stripping Automated Endothelial Keratoplasty

Retrospective contralateral study comparing Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty

“…1,6,10,[24][25][26] Other studies suggest that the stroma lamella is responsible for a posterior astigmatism, a hyperopic shift and altered higher-order optical aberrations after DSAEK. 1,8,[14][15][16][17]27 In our study, we found no difference in total HOA, astigmatism, and spherical equivalent between DSAEK and DMEK. In both groups, changes in mean spherical equivalent and astigmatism were small.…”

“…The stroma lamella seems to be responsible for a posterior astigmatism, a hyperopic shift and altered higher-order optical aberrations resulting in a poorer visual acuity. 1,8,[14][15][16][17] Otherwise the DSAEK procedure allows a safer donor preparation and easier manipulation in the anterior chamber because of higher stability of the relatively thick graft. 1,18,19 These different aspects possibly influence the patient's satisfaction and preference for one or the other surgical procedure.…”

Ray-tracing intraocular lens power calculation using anterior segment optical coherence tomography measurements

“…As seen in Figure 2, the refractive error varied with the posterior corneal curvature, and it might deviate from normal in cases that had LASIK for high myopia, which carries the risk for a forward shift in the posterior corneal surface 26 and after Descemet stripping automated endothelial keratoplasty. 27,28 The current study found that a steeper posterior curvature led to a postoperative hyperopic shift. We conclude that use of both corneal surface measurements with AS-OCT suppresses the effect of the posterior corneal curvature.…”

Graft profile and thickness as a function of cut transition speed in Descemet-stripping automated endothelial keratoplasty

“…Close inspection of postoperative OCT images published by Scoria et al 2 (their Figure 1) suggests asymmetry in peripheral donor thickness persists 1 year after surgery.…”

“…Insertion of a corneal lenticule acts as an additional lens and creates a new optical interface. Postoperative imaging studies suggest that variations in the ratio of central to peripheral graft thickness produce a hyperopic refractive shift in many patients [2][3][4] and that posterior corneal astigmatism is increased relative to that in unoperated eyes. 5,6 Anterior segment optical coherence tomography (AS-OCT) has been validated as an accurate, fast noncontact method for performing regional corneal pachymetry.…”