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Updated: Apr 30, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Optical quality of the cornea after Descemet membrane endothelial keratoplasty
Korine van Dijk1, Konstantinos Droutsas2, Jingzhen Hou3
1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Netherlands; Melles Cornea Clinic, Rotterdam, Netherlands.
Purpose:
To evaluate corneal higher-order aberrations (HOAs) and backscattered light before and after Descemet membrane endothelial keratoplasty (DMEK) and their correlation with visual outcome.
Design:
Retrospective study.
Methods:
In a total of 118 consecutive eyes of 118 patients who underwent uneventful DMEK for Fuchs endothelial dystrophy at a tertiary referral center, best spectacle-corrected visual acuity (BSCVA), corneal HOAs, and backscattered light were evaluated preoperatively and at 6 months postoperatively. Outcome data were compared to an age-matched control group with uncomplicated eyes (n = 27).
Results:
Compared to the control group, Fuchs endothelial dystrophy eyes, before as well as 6 months after DMEK, showed higher values of anterior and posterior HOAs and backscattered light (P < .033). Postoperative anterior HOAs and backscattered light (0-2 mm) were associated with lower 6-month BSCVA (positively related with logMAR BSCVA) (P ≤ .020). Anterior corneal HOAs did not change from preoperative to 6 months after DMEK (P = .649), while total posterior HOAs (RMS third to sixth Zernike order) and haze decreased (P < .001).
Conclusions:
Anterior and posterior corneal HOAs, as well as backscattered light from the cornea, were elevated in eyes suffering from Fuchs endothelial dystrophy and remained higher throughout 6 months after DMEK. If present, anterior surface irregularities and anterior corneal haze may be the most important limiting factors in visual rehabilitation after DMEK.
