[Refractive changes after different modifications of endothelial keratoplasty]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Error

Background:

• Endothelial keratoplasty techniques like DSAEK and DMEK are used to treat corneal endothelial dysfunction.
• Understanding refractive outcomes and corneal changes is crucial for patient management.

Purpose of the Study:

• To evaluate clinical refraction changes after DSAEK and DMEK.
• To assess the correlation between transplant thickness and refractive outcomes.
• To compare visual acuity and aberrations between DSAEK and DMEK.

Main Methods:

• Comparative study of 40 eyes post-DSAEK and 20 eyes post-DMEK.
• Control group of 20 healthy eyes.
• Measurements included central corneal thickness, transplant thickness, optical coherence tomography, computed tomography, and aberrometry (Pentacam).

Main Results:

• DMEK group showed higher best-corrected visual acuity (0.2 at 6 months, 0.1 at 1 year) compared to DSAEK.
• DSAEK induced hyperopic shifts and 0.4 D astigmatism; DMEK induced minimal astigmatism (≤0.1 D).
• Corneal thickness stabilized earlier in DMEK (3-4 months) vs. DSAEK (6-7 months). Posterior aberrations were lower in DMEK.

Conclusions:

• DMEK demonstrates superior visual and refractive outcomes compared to DSAEK.
• DMEK leads to faster visual rehabilitation and fewer posterior corneal aberrations.
• Both procedures increase higher-order aberrations compared to healthy corneas.