Refractive Change After Descemet Stripping Automated Endothelial Keratoplasty Surgery and Its Correlation With Graft Thickness and Diameter

Abstract

Our study of DSAEK grafts demonstrated a hyperopic refractive shift after DSAEK surgery. This observation should be taken into consideration when deciding on the appropriate intraocular lens power in DSAEK triple surgery and may also aid in anticipating refractive outcomes after pseudophakic DSAEK surgery. Further studies to follow these refractive changes over a longer follow-up period and to investigate the mechanism of this refractive change after DSAEK surgery are warranted.

Analysis of posterior donor corneal parameters 1 year after Descemet stripping automated endothelial keratoplasty (DSAEK) triple procedure

“…Graft diameter was quite homogeneous in this series of eyes (9% of eyes received 9.00 mm donor button, 50% 8.50 mm and 41% 8.00 mm); on the other hand, a statistically positive correlation between lenticule diameter and induced refractive shift was calculated in this series, similarly to that reported by a previous work [12], in which graft diameters ranged between 7.00 and 9.00 mm.…”

“…On the other hand, such an approach can yield to error due to the variability in amount of hyperopic shift between patients: donor lenticule parameters have been hypothesized to be the main factors of postoperative refractive inaccuracy [11][12][13][14][15].…”

“…To date, a few preliminary works [11][12][13][14][15] aimed to quantify how the various donor corneal parameters may influence the ultimate refractive outcome following DSAEK with or without combined phacoemulsification and implantation of intraocular lens (IOL), namely the DSAEK triple procedure.…”

Descemet-stripping automated endothelial keratoplasty in eyes with toxic anterior segment syndrome after cataract surgery

“…Donor lenticule thickness obtained with a 350 mm head has been reported to vary widely and to be as thin as 58 mm. 15 In addition, some tissue cut with a 350 mm head are thicker than expected (G75 mm), leaving the remaining lenticule thinner. 16 Jones et al 17 showed that the 350 mm microkeratome head resulted in deeper keratectomy, leading to a thinner mean residual stromal bed than planned preoperatively.…”

Study of factors for unsuitability of DSAEK in cases of corneal decompensation following cataract surgery

“…While DLEK showed some promise initially, the simplicity of the surgical technique of DSAEK has made it a preferred choice of many corneal transplant surgeons. DSAEK has many advantages over the standard keratoplasty procedure for the treatment of endothelial dysfunction, including better retention of corneal integrity, better visual recovery with minimal effect on refraction and lack of suture associated complications [10,11]. These benefits translate into better visual outcome and patient comfort and have catapulted DSAEK to its present status as the procedure of choice in cases of endothelial dysfunction [12].…”