Abstract

PURPOSE: To compare changes in corneal power measurements after Descemet membrane endothelial keratoplasty (DMEK) vs. ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK).SETTING: Hospital centers DESIGN: : Post-hoc sub-analysis of the randomized controlled DETECT Trial METHODS: : 50 eyes (38 patients) with endothelial dysfunction from Fuchs' endothelial dystrophy or pseudophakic bullous keratopathy were randomized to DMEK or UT-DSAEK 1 to 2 days prior to surgery. Total Corneal Refractive Power (TCRP) and anterior/posterior simulated keratometry were obtained using Scheimpflug imaging preoperatively (baseline) and postoperatively at 3, 6, 12, and 24 months. Spectacle refractions were performed at 6, 12, and 24 months after surgery.RESULTS: Mean hyperopic shift of TCRP from baseline to 12 months was 0.80±1.1 (p=0.002) in the DMEK group and 0.69±0.84 (p<0.001) in the UT-DSAEK group. Posterior corneal curvature (Km) steepened (more negative dioptric power) by 0.42±0.10 (p<0.001) in DMEK and 0.54±0.09 (p<0.001) in UT-DSAEK. Mean change in TCRP and posterior corneal curvature did not differ between DMEK and UT-DSAEK (TCRP, p=0.71; posterior Km, p=0.36).CONCLUSIONS: Sustained steepening in posterior corneal curvature with loss in total corneal power contributes to hyperopic shifts after endothelial keratoplasty. Changes in corneal measurements do not differ between DMEK and UT-DSAEK.

View details for DOI 10.1016/j.ajo.2022.07.009

View details for PubMedID 35870491