Optical characteristics after Descemet membrane endothelial keratoplasty: 1-year results

To evaluate the corneal characteristics after Descemet membrane endothelial keratoplasty (DMEK) compared with normal corneas.

Patients who underwent DMEK at Yokohama Minami Kyosai Hospital were included and prospectively evaluated pre-operatively and at postoperative months 1, 3, 6, and 12, and compared to healthy controls. Corneal characteristics evaluated included corneal curvature (keratometric value [KV]; D), central corneal thickness (CCT), peripheral corneal thickness (PCT), and corneal higher-order aberrations [HOAs] at 6.0 mm diameter, calculated by anterior segment optical coherence tomography and logarithm of the minimal angle of resolution [logMAR].

A total of 30 eyes of 30 patients (6 men, 24 women, mean age 73.4 ± 7.4 years) were included and compared with 31 age-matched healthy control eyes (13 men, 18 women; mean age 73.0 ± 6.7 years). LogMAR after DMEK improved from 0.87 ± 0.07 preoperatively to 0.04 ± 0.07 at 12 months postoperatively (p<0.001). Although anterior KVs of DMEK eyes were similar to those of control eyes, posterior KVs were significantly larger (-6.4 ± 0.3 D vs. -6.3 ± 0.2 D; p = 0.02). Total HOAs after DMEK improved from 1.94 ± 1.05 μm preoperatively to 1.05 ± 0.16 μm at 12 months postoperatively (p<0.001), which was significantly higher than that in control eyes (0.63 ± 0.06) (p<0.001). Despite the similar CCTs in the two groups, the PCT was significantly larger in DMEK eyes (704 ± 41 μm vs 669 ± 38 μm, p = 0.002) at 12 months.

Despite achieving good visual function and excellent corneal clarity, eyes that underwent DMEK showed a steeper posterior KV and higher corneal HOAs than normal eyes even at 12 months after surgery.