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- Title
Effects of corneal irregular astigmatism on visual acuity after conventional and femtosecond laser-assisted Descemet's stripping automated endothelial keratoplasty.
- Authors
Tomida, Daisuke; Yamaguchi, Takefumi; Ogawa, Akiko; Hirayama, Yumiko; Shimazaki-Den, Seika; Satake, Yoshiyuki; Shimazaki, Jun
- Abstract
Purpose: To compare short-term outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using a graft prepared with either a femtosecond laser or a microkeratome. Methods: Thirty-eight patients underwent DSAEK with grafts prepared with either a femtosecond laser (f-DSAEK; 21 eyes) or a microkeratome (m-DSAEK; 17 eyes). Visual acuity, endothelial cell density, regular astigmatism and irregular astigmatism were compared between the two groups preoperatively and at 1, 3, and 6 months post-operatively. Fourier analysis was conducted to calculate astigmatism of the anterior and posterior surfaces, and total cornea, using anterior segment optical coherence tomography (AS-OCT). Results: Visual acuity (logMAR) improved from 1.20 ± 0.60 to 0.43 ± 0.25 after m-DSAEK ( P < 0.001) and from 1.20 ± 0.57 to 0.77 ± 0.33 after f-DSAEK ( P = 0.0028) at 6 months following DSAEK. Visual acuity after m-DSAEK was significantly better than after f-DSAEK at 1, 3, and 6 months ( P < 0.05). AS-OCT corneal images revealed greater irregularities on the posterior surfaces of f-DSAEK grafts compared to m-DSAEK grafts. Irregular astigmatism of the total cornea and the posterior surface was significantly larger after f-DSAEK than after m-DSAEK, although there was no significant difference in irregular astigmatism of the anterior surface at 6 months. Postoperative visual acuity was significantly correlated with the postoperative irregular astigmatism of the total cornea ( r = 0.6657 and P < 0.001) and the anterior ( r = 0.416, P = 0.016) and posterior surfaces ( r = 0.7046, P < 0.001). Conclusions: Visual outcomes after f-DSAEK were poor compared to conventional m-DSAEK due to an increase in irregular astigmatism caused by posterior surface irregularities.
- Subjects
ASTIGMATISM; VISUAL acuity; FEMTOSECOND lasers; CORNEA surgery; OPTICAL aberrations; ENDOTHELIAL cells; FOURIER analysis
- Publication
Japanese Journal of Ophthalmology, 2015, Vol 59, Issue 4, p216
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-015-0388-y