Correlation between visual acuity and interface reflectivity measured by pentacam following DSAEK.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Optical Science

Background:

• Descemet-stripping automated endothelial keratoplasty (DSAEK) offers faster visual rehabilitation than penetrating keratoplasty but may have suboptimal visual outcomes compared to Descemet membrane endothelial keratoplasty (DMEK).
• Reduced visual performance in DSAEK cases without graft failure often lacks a clear explanation.

Purpose of the Study:

• To investigate the correlation between visual acuity after DSAEK and interface reflectivity measured by a rotating Scheimpflug system.
• To identify potential correlates for reduced optical performance in DSAEK.

Main Methods:

• 14 eyes from 13 patients undergoing DSAEK were analyzed using a Pentacam system 2-11 months post-surgery.
• Interface reflectivity and central corneal thickness were measured.
• Multifactorial linear regression analyzed correlations between reflectivity, best spectacle-corrected visual acuity (BSCVA), central corneal thickness, and follow-up duration.

Main Results:

• A statistically significant inverse correlation was found between interface reflectivity and BSCVA.
• Interface reflectivity was significantly correlated with follow-up time.
• Highest reflectivity was observed in areas with interface (metal) particles.
• No significant correlation was found between interface reflectivity and central corneal thickness.

Conclusions:

• Interface reflectivity serves as a measurable correlate for reduced visual outcomes in DSAEK, even with clear grafts.
• Increased interface reflectivity, potentially caused by particles or scarring, is associated with poorer visual acuity following DSAEK.
• This finding highlights the impact of interface irregularities on the optical quality after DSAEK.