Characteristics of preoperative and postoperative astigmatism in patients having Descemet membrane endothelial keratoplasty

Shajari, Mehdi; Kolb, Carolin M.; Mayer, Wolfgang J.; Agha, Bishr; Steinwender, Gernot; Dirisamer, Martin; Priglinger, Siegfried; Kohnen, Thomas und Schmack, Ingo (2019): Characteristics of preoperative and postoperative astigmatism in patients having Descemet membrane endothelial keratoplasty. In: Journal of Cataract and Refractive Surgery, Bd. 45, Nr. 7: S. 1001-1006

Abstract

Purpose: To evaluate the characteristics of preoperative and postoperative astigmatism in patients having Descemet membrane endothelial keratoplasty (DMEK). Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Design: Retrospective case series. Methods: Measurements were obtained using a Scheimpflug camera (Pentacam AXL) preoperatively and 3 months and 12 months postoperatively. Values of front and back astigmatism and total astigmatism in the central 4.0 mm diameter zone (TCA4) were analyzed. Results: Fifty-three eyes of 45 patients were included. The prevalence of TCA4 above 1.0 diopter (D) was considerably higher (79%) and with-the-rule astigmatism was less frequent in this cohort of European patients with Fuchs endothelial dystrophy (mean age 65 years) than that reported in a meta-analysis of healthy European eyes. The TCA4 values correlated with anterior astigmatism preoperatively and postoperatively (P < .001) and with posterior astigmatism at the 1-year follow-up (P < .01). Although, no correlation was found between the preoperative and 1-year results for anterior astigmatism (P = .12), posterior astigmatism (P = .35), or total corneal astigmatism (P = .47), the difference in vector analysis between the two measurements was only 0.01 at 109 degrees, 0.03 at 98 degrees, and 0.02 at 157 degrees, respectively. However, the greater the difference between the preoperative TCA3 and preoperative TCA5 values, the greater the decrease in corneal astigmatism (P < .001). Conclusions: The percentage of eyes with corneal astigmatism above 1.0 D was higher preoperatively and postoperatively in patients with Fuchs endothelial dystrophy than in a healthy population. Predicting postoperative astigmatism based on preoperative results is not possible;however, in eyes with a high difference between TCA3 and TCA5, a reduction in corneal astigmatism after DMEK is likely. (C) 2019 ASCRS and ESCRS

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0886-3350
• Sprache: Englisch