Changes in Anterior, Posterior, and Total Corneal Astigmatism after Descemet Membrane Endothelial Keratoplasty

Alnawaiseh, Maged; Zumhagen, Lars; Rosentreter, André; Eter, Nicole

doi:10.1155/2017/4068963

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…Our findings are in accordance with a study performed by Yokogawa et al, which also showed a significant decrease in the magnitude of the posterior corneal astigmatism after DMEK surgery [19]. Along with a reduction of the magnitude of posterior corneal astigmatism, we also detected a shift in axis orientation to a higher proportion of eyes with ATR astigmatism, which is similar to results reported by Alnawaiseh et al [20]. In a study with nondiseased, previously unoperated eyes, total corneal astigmatism could not be predicted adequately by anterior measurements only, especially in eyes that do not have with-the-rule astigmatism, pointing out the relevance of posterior corneal profile [21].…”

Section: Discussionsupporting

confidence: 93%

Refractive outcome and tomographic changes after Descemet membrane endothelial keratoplasty in pseudophakic eyes with Fuchs’ endothelial dystrophy

et al. 2021

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Purpose To analyze refractive and topographic changes secondary to Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic eyes with Fuchs’ endothelial dystrophy (FED). Methods Eighty-seven pseudophakic eyes of 74 patients who underwent subsequent DMEK surgery for corneal endothelial decompensation and associated visual impairment were included. Median post-operative follow-up time was 12 months (range: 3–26 months). Main outcome measures were pre- and post-operative manifest refraction, anterior and posterior corneal astigmatism, simulated keratometry (CASimK) and Q value obtained by Scheimpflug imaging. Secondary outcome measures included corrected distance visual acuity (CDVA), central corneal densitometry, central corneal thickness, corneal volume (CV), anterior chamber volume (ACV) and anterior chamber depth (ACD). Results After DMEK surgery, mean pre-operative spherical equivalent (± SD) changed from + 0.04 ± 1.73 D to + 0.37 ± 1.30 D post-operatively (p = 0.06). CDVA, proportion of emmetropic eyes, ACV and ACD increased significantly during follow-up. There was also a significant decrease in posterior corneal astigmatism, central corneal densitometry, central corneal thickness and corneal volume over time (p = 0.001). Only anterior corneal astigmatism and simulated keratometry (CASimK) remained fairly stable after DMEK. Conclusion Despite tendencies toward a hyperopic shift, changes in SE were not significant and refraction remained overall stable in pseudophakic patients undergoing DMEK for FED. Analysis of corneal parameters by Scheimpflug imaging mainly revealed changes in posterior corneal astigmatism pointing out the relevance of posterior corneal profile changes during edema resolution after DMEK.

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Section: Discussionsupporting

confidence: 93%

Refractive outcome and tomographic changes after Descemet membrane endothelial keratoplasty in pseudophakic eyes with Fuchs’ endothelial dystrophy

et al. 2021

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“… 17 There is also a concern about modification of the orientation of the posterior corneal astigmatism after DMEK; however, the change of its magnitude and orientation may or may not be significant. 18 …”

Section: Discussionmentioning

confidence: 99%

Toric IOL in Combined DMEK and Cataract Surgery

Trindade¹,

Garcia²,

Nogueira³

2021

OPTH

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Introduction Descemet membrane endothelial keratoplasty (DMEK) is the current gold standard surgical procedure to treat Fuchs endothelial keratoplasty. Cataract removal and intraocular lens (IOL) implantation can be safely combined with this corneal procedure. This paper presents a case series in which a toric intraocular lens (IOL) was used in combined DMEK and cataract surgery to correct corneal astigmatism. Methods Four eyes that had a toric IOL implanted in combined cataract and DMEK surgery were included. Results There was a reduction in manifest refractive cylinder and improvement in uncorrected and best-corrected vision in all cases. Discussion Surgeons may consider the use of toric IOLs in selected cases of combined DMEK and cataract surgery for Fuchs endothelial dystrophy.

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“…Since the introduction of the DMEK technique, changes in endothelial cell count (ECC), best corrected visual acuity (BCVA), and central corneal thickness (CCT) after surgery have been widely studied [7,[10][11][12][13]. ere are only a few reports analyzing postoperative corneal aberrations [14][15][16], keratometry [17][18][19], and astigmatism changes [20][21][22]. Regrettably, there are few studies that assess the dynamics of changes in corneal parameters over time in a detailed way.…”

Section: Introductionmentioning

confidence: 99%

Changes in Corneal Parameters after DMEK Surgery: A Swept-Source Imaging Analysis at 12-Month Follow-Up Time

Machalińska

Kuligowska

Kaleta

et al. 2021

Journal of Ophthalmology

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Purpose. To assess the time course changes in corneal topographic parameters during the one-year follow-up after Descemet membrane endothelial keratoplasty (DMEK) surgery. Materials and Methods. Twenty-one patients (24 eyes) who underwent DMEK surgery were evaluated. Best corrected visual acuity (BCVA), endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA), and higher-order aberration (HOA) were assessed at baseline and 1, 3, 6 and 12 months after the surgery using CASIA2 anterior segment swept-source OCT (Tomey, Japan). Results. In patients who underwent DMEK surgery, BCVA improved gradually at the subsequent visits during the 12-month follow-up. A significant reduction in ECC and CCT at the 1st month was noted, which remained stable until the 6th month postoperatively. Anterior and total MK values remained unchanged, whereas changes in posterior keratometry were noticeable until the 6th month after surgery. A significant reduction in the anterior, posterior, and total astigmatism magnitude as well as astigmatism asymmetry was observed during the first 6 months after surgery. A gradual anterior, posterior, and total HOA decrease was documented until the 12th month after surgery. Negative correlations between baseline values of CCT, MK, MA, AA, and HOA and postoperative variations in those parameters at consecutive follow-up time points were observed. Accordingly, negative correlations between baseline CCT and postoperative changes in corneal topographic parameters after surgery were found. Conclusion. The stabilization of most corneal topographic parameters takes place within 6 months after the procedure, whereas HOA reduction and BCVA improvement gradually occur during the first year after surgery. Preoperative values of corneal topographic parameters strongly determine their changes detected after DMEK surgery, which may suggest that early therapeutic intervention results in better visual outcomes.

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Changes in Anterior, Posterior, and Total Corneal Astigmatism after Descemet Membrane Endothelial Keratoplasty

Cited by 9 publications

References 27 publications

Refractive outcome and tomographic changes after Descemet membrane endothelial keratoplasty in pseudophakic eyes with Fuchs’ endothelial dystrophy

Refractive outcome and tomographic changes after Descemet membrane endothelial keratoplasty in pseudophakic eyes with Fuchs’ endothelial dystrophy

Toric IOL in Combined DMEK and Cataract Surgery

Changes in Corneal Parameters after DMEK Surgery: A Swept-Source Imaging Analysis at 12-Month Follow-Up Time

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