[Comparative study of corneal densitometry values after posterior lamellar keratoplasty]

Studying clinical and functional outcomes of femtosecond laser-assisted posterior lamellar keratoplasty is an actual problem in endothelial keratoplasty.

To compare the values of corneal densitometry (CD) as measured by the Scheimpflug camera (Pentacam) following femtosecond laser-assisted Descemet stripping endothelial keratoplasty (DSEK) vs microkeratome-assisted Descemet Stripping Automated Endothelial Keratoplasty (DSAEK).

The prospective single center randomized study included 37 eyes of 37 patients with Fuchs endothelial dystrophy and cataract. 20 patients underwent cataract phacoemulsification combined with Femto-DSEK; 17 patients of the control group underwent cataract phacoemulsification combined with DSAEK. Outcome measurements included optical coherence tomography of the anterior segment of the eye, endothelial microscopy and densitometry. Optical density of the cornea and its various layers: anterior layer (AL), central layer (CL), posterior layer (PL) and interface zone was assessed in the 0-2 and 2-6 mm zones. The follow-up period lasted 1 year.

Comparative analysis did not reveal statistically significant differences in AL, CL, and CCT values between the groups (p>0.05). In the Femto-DSEK group, densitometry indices of the posterior layers of the cornea and the interface zone were significantly higher than in the DSAEK group (p<0.05). Postoperative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) differed significantly throughout all follow-up period with DSAEK group having better results (p<0.05). Endothelial cell density (ECD) at 12 months was higher in the Femto-DSEK group compared with the DSAEK group (65.7±7.7% and 58.5±8.1%, p=0.02, respectively).

After one year, corneal density values (AL, CL, PL) and CCT were comparable between the groups. UCVA, BSCVA and ECD were significantly better after DSAEK.