Related Experiment Video
Updated: Mar 2, 2026

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Decreased Visual Acuity by an Irregular Corneal Posterior Surface After Repeat Descemet Stripping Automated
Hiroyuki Yazu1, Takefumi Yamaguchi, Murat Dogru
1Department of Ophthalmology (H.Y., T.Y., M.D., Y.S., K.T., J.S.), Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan; Department of Ophthalmology (H.Y.), Hino Municipal Hospital, Tokyo, Japan; and Department of Ophthalmology (H.Y.), Keio University School of Medicine, Tokyo, Japan.
Purpose:
To investigate the impact of higher-order aberrations (HOAs) on visual acuity after repeat Descemet stripping automated endothelial keratoplasty (DSAEK) in the same eyes.
Methods:
This retrospective comparative case series includes 23 patients who underwent DSAEK twice in the same eyes (46 DSAEK in total). We evaluated the HOAs of the anterior and posterior corneal surfaces, and total cornea using the Fourier analysis data from anterior segment optical coherence tomography. Eyes were divided into one of the following groups, based on the improvement and decline in the best-corrected visual acuity (BCVA) after repeat DSAEK; group A: 12 eyes with an improvement ≥ 2 lines, group B: 12 eyes with a decline ≤ 2 lines, and group C: 11 eyes with no change or change within 1 line.
Results:
The HOAs of the posterior surface in group B were significantly greater than those of group A (P=0.028), whereas there were no significant differences in the anterior surface and total corneal HOAs between groups A and B (P=0.12 and 0.08). There were no significant differences in the anterior and posterior surface as well as total cornea HOAs between initial DSAEK and repeat DSAEK in group C (P=0.87, 0.65, and 0.42). The postoperative BCVA had a significant correlation with the HOAs of the anterior and posterior surfaces as well as the total cornea (R=0.40, 0.46, and 0.53; P=0.01, 0.002, and 0.001).
Conclusions:
Posterior corneal HOAs can have a negative influence on the visual acuity after endothelial keratoplasty.
Related Concept Videos
Glaucoma: Overview
Photoreceptors and Visual Pathways
Angle Closure Glaucoma: Treatment
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Focusing of Light in the Eye

