Posterior Corneal Curvature Changes After Pre-Descemet's Endothelial Keratoplasty: A Prospective Analysis

To assess the changes in the posterior corneal curvature after pre-Descemet's endothelial keratoplasty (PDEK) and correlate with the visual outcomes.

Eyes with pseudophakic bullous keratopathy, aphakic bullous keratopathy, and Fuchs dystrophy undergoing PDEK were included. The main outcome measures were the topography (OrbscanIIz, Bausch and Lomb) indices-total corneal power (TCP) in diopters (D), radius of the posterior curvature (mm), and best-fit sphere of the posterior corneal surface (BFS in D) at preoperative and postoperative 1 month, 3 months, and 6 months.

Overall, 43 eyes of 43 patients with a mean age of 68 ± 9.6 years were studied. The mean preoperative TCP 43.1 D ± 2.3 reduced to 42.4 D ± 2.6 at 3 months (P < 0.010). There was a statistically significant decrease in the mean posterior corneal curvature at 1 month and 3 months postoperatively (P = 0.002). There was no significant change in the TCP and posterior corneal curvature at 6 months (P > 0.05). The mean BFS showed an increase at 1 month (53.45 ± 5.2 D) and 3 months (52.95 ± 5.1 D) and decrease at 6 months (51.90 ± 5.3 D). The overall change in BFS (P > 0.05) was not significant. There was significant improvement in visual acuity (P < 0.05). The best-corrected visual acuity was ≥20/40 in 79.07% and ≥20/60 in 100% at 6 months. There was no statistically significant correlation between the change in the best-corrected visual acuity and TCP, posterior corneal curvature, or BFS.

Although there was immediate postoperative change in the posterior curvature, no significant change was induced by PDEK.