Corneal Haze Determined by Confocal Microscopy 2 Years After Descemet Stripping With Endothelial Keratoplasty for Fuchs Corneal Dystrophy

Abstract

Visual function after DSEK is affected by residual haze in the anterior host cornea more so than the surgical interface. Haze, which likely is experienced as glare disability, improves after surgical intervention but improves more in younger patients.

The pathophysiology of Fuchs' endothelial dystrophy – A review of molecular and cellular insights

“…6) (Alomar et al, 2011;Baratz et al, 2012). Light and electron microscopy studies of FECD buttons removed at keratoplasty have confirmed the presence of fibrous connective tissue between the epithelium and Bowman's layer (Naumann and SchlotzerSchrehardt, 2000).…”

Determinants of visual quality after endothelial keratoplasty

“…127 Subepithelial, anterior stromal and interface haze has been found to persist for up to two years after EK, although there is a tendency for improvement. 15,94 The anterior recipient cornea has been shown to be the primary source of haze after DSEK and DLEK. 15,77,94 A confocal microscopy study of DSAEK found that haze reduced between one and six months after surgery, and that subepithelial and interface haze persisting at six months was a risk factor for decreased visual performance.…”

“…15,94 The anterior recipient cornea has been shown to be the primary source of haze after DSEK and DLEK. 15,77,94 A confocal microscopy study of DSAEK found that haze reduced between one and six months after surgery, and that subepithelial and interface haze persisting at six months was a risk factor for decreased visual performance. 64 Accordingly, good preoperative vision secondary to milder anterior corneal changes is a predictor of better visual outcomes postoperatively.…”

Fuchs Corneal Dystrophy

“…5 Confocal microscopy suggests that after endothelial transplantation, subepithelial haze rather than interface haze is the predominant source of forward light scatter. 6 Collagen fibers in the anterior stroma are tightly packed relative to the posterior stroma, in which fibrils have less connections. As a result, corneal edema results in increased hydration of the posterior cornea and bulging of the posterior stroma into the anterior chamber.…”