The Contribution of the Posterior Surface to the Corneal Aberrations in Eyes after Keratoplasty

Yamaguchi, Takefumi; Ohnuma, Kazuhiko; Tomida, Daisuke; Konomi, Kenji; Satake, Yoshiyuki; Negishi, Kazuno; Tsubota, Kazuo; Shimazaki, Jun

doi:10.1167/iovs.11-7647

Cited by 82 publications

(73 citation statements)

References 24 publications

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“…Theories include a more regular posterior graft surface with greater thickness uniformity , 31,77,112 thinner grafts with a better match in curvature, and improved parallelism between the graft and recipient and improved optical compensation by the posterior cornea. 139 Posterior corneal HOAs are increased after all forms of EK compared with normal controls, 21,54,84,108,137 and posterior corneal HOAs after DSAEK seem to be comparable to or greater than post-PKP. 21,108 It has been suggested that the posterior corneal surface is the source of increased whole-eye HOAs after DSEK compared with normal eyes or eyes post-PKP.…”

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 88%

“…This has led some authors to reason that changes in the posterior cornea should not affect visual acuity. 54,138 Although correlation has been demonstrated between anterior corneal HOAs and postoperative BCVA, 84,108,137,139 several studies have failed to find a similar association between posterior corneal HOAs and postoperative BCVA. 68,81,84,133,137 Despite this, the impact of the posterior corneal surface on visual outcomes should not be ignored.…”

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

“…The internal optics of the eye (posterior corneal surface and crystalline lens) directly oppose and reduce anterior corneal aberrations in normal eyes, 9,33,62,118,139 with compensation by the posterior corneal surface leading to an overall reduction in whole eye HOAs. Posterior corneal changes after EK affect its parallelism with the anterior corneal surface.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…139 These changes include tilt and decentration, which have both been reported to increase whole-eye HOAs in the context of intraocular lenses, 16,35 and increased corneal thickness. 139 Disruption of parallelism may reduce the compensatory ability of the posterior cornea, exaggerating the effects of anterior corneal irregularity and increasing whole eye HOAs, 54,77,139 and negatively impacting the modulation transfer function. 139 Using Scheimpflug 3D-reconstruction and ray-tracing in normal eyes, Dubbelman et al found that the posterior cornea compensated for 3.5% of the anterior corneal coma aberration.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…139 Disruption of parallelism may reduce the compensatory ability of the posterior cornea, exaggerating the effects of anterior corneal irregularity and increasing whole eye HOAs, 54,77,139 and negatively impacting the modulation transfer function. 139 Using Scheimpflug 3D-reconstruction and ray-tracing in normal eyes, Dubbelman et al found that the posterior cornea compensated for 3.5% of the anterior corneal coma aberration. 32 In a wavefront study of keratoconus eyes, Chen et al found that the posterior cornea compensated for 14-24% of the coma aberration of the anterior cornea.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.

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Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 88%

Section: Influence Of the Posterior Cornea (Donor Graft)mentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

See 3 more Smart Citations

Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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Effects of Graft Thickness and Asymmetry on Visual Gain and Aberrations After Descemet Stripping Automated Endothelial Keratoplasty

Dickman

Cheng²,

Berendschot³

et al. 2013

JAMA Ophthalmol

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Importance: Understanding the contribution of graft thickness and asymmetry to visual gain and posterior corneal (PC) higher-order aberrations (HOAs) may assist optimizing visual outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK).Objective: To investigate the effects of graft thickness and asymmetry on visual gain and aberrations after DSAEK.Design: Retrospective analysis of an interventional case series of eyes undergoing DSAEK. Visual gain was defined as the difference between preoperative and 6-month postoperative best-corrected visual acuity in logMAR equivalents. Graft thickness was measured by anterior-segment optical coherence tomography. Corneal topography and HOAs were measured by Scheimpflug imaging. Raw posterior corneal (PC) elevation data were exported and fitted against a bestfitted sphere, providing a measure of donor lenticule asymmetry. Correlation analysis was performed among visual gain, graft thickness, graft asymmetry, and PC HOAs.

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Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus

Keane

Coster

Ziaei

et al. 2014

Cochrane Database of Systematic Reviews

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Analysis 1.2. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 2 Postoperative BCVA (varied follow-up times, post-suture removal) (LogMAR).. .. .. .. .. .. Analysis 1.3. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 3 Postoperative functional BCVA achieved (varied follow-up times, post-suture removal).. .. .. .. . Analysis 1.4. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 4 Postoperative UCVA (varied follow-up times, post-suture removal) (LogMAR).. .. .. .. .. .. Analysis 1.5. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 5 Postoperative functional UCVA achieved (varied follow-up times, post-suture removal).. .. .. .. . Analysis 1.6. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 6 Postoperative keratometric astigmatism (varied follow-up times, post-suture removal) (D).. .. .. .. Analysis 1.7. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 7 Postoperative spherical equivalent (varied follow-up times, post-suture removal) (D).. .. .. .. .. Analysis 1.8. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 8 Postoperative keratometric astigmatism (12 months

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The Contribution of the Posterior Surface to the Corneal Aberrations in Eyes after Keratoplasty

Abstract: Posterior surfaces compensate for anterior aberrations in normal, PK, and DALK eyes. In DSAEK eyes, the posterior surface increased total corneal HOAs and had a negative influence on MTFs.

Cited by 82 publications

References 24 publications

Determinants of visual quality after endothelial keratoplasty

Determinants of visual quality after endothelial keratoplasty

Effects of Graft Thickness and Asymmetry on Visual Gain and Aberrations After Descemet Stripping Automated Endothelial Keratoplasty

Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus

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