Effects of corneal irregular astigmatism on visual acuity after conventional and femtosecond laser-assisted Descemet’s stripping automated endothelial keratoplasty

Daisuke Tomida, Takefumi Yamaguchi, Akiko Ogawa, Yumiko Hirayama, Seika Shimazaki-Den, Yoshiyuki Satake, Jun Shimazaki

研究成果: Article

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Purpose: To compare short-term outcomes of Descemet’s stripping automated endothelial keratoplasty (DSAEK) using a graft prepared with either a femtosecond laser or a microkeratome. Methods: Thirty-eight patients underwent DSAEK with grafts prepared with either a femtosecond laser (f-DSAEK; 21 eyes) or a microkeratome (m-DSAEK; 17 eyes). Visual acuity, endothelial cell density, regular astigmatism and irregular astigmatism were compared between the two groups preoperatively and at 1, 3, and 6 months post-operatively. Fourier analysis was conducted to calculate astigmatism of the anterior and posterior surfaces, and total cornea, using anterior segment optical coherence tomography (AS-OCT). Results: Visual acuity (logMAR) improved from 1.20 ± 0.60 to 0.43 ± 0.25 after m-DSAEK (P < 0.001) and from 1.20 ± 0.57 to 0.77 ± 0.33 after f-DSAEK (P = 0.0028) at 6 months following DSAEK. Visual acuity after m-DSAEK was significantly better than after f-DSAEK at 1, 3, and 6 months (P < 0.05). AS-OCT corneal images revealed greater irregularities on the posterior surfaces of f-DSAEK grafts compared to m-DSAEK grafts. Irregular astigmatism of the total cornea and the posterior surface was significantly larger after f-DSAEK than after m-DSAEK, although there was no significant difference in irregular astigmatism of the anterior surface at 6 months. Postoperative visual acuity was significantly correlated with the postoperative irregular astigmatism of the total cornea (r = 0.6657 and P < 0.001) and the anterior (r = 0.416, P = 0.016) and posterior surfaces (r = 0.7046, P < 0.001). Conclusions: Visual outcomes after f-DSAEK were poor compared to conventional m-DSAEK due to an increase in irregular astigmatism caused by posterior surface irregularities.

元の言語English
ページ(範囲)216-222
ページ数7
ジャーナルJapanese Journal of Ophthalmology
59
発行部数4
DOI
出版物ステータスPublished - 2015 7 23

ASJC Scopus subject areas

  • Ophthalmology

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