Anterior Corneal High-order Aberrations in Fuchs' Endothelial Corneal Dystrophy Classified by Scheimpflug Tomography

Visual acuity may be limited after endothelial keratoplasty in Fuchs' endothelial corneal dystrophy. This may be due to increased anterior high-order aberrations that persist after endothelial keratoplasty. It is not clear at what stage these aberrations begin. We aimed to evaluate how subclinical corneal edema affects anterior corneal high-order aberrations.

We aimed to evaluate anterior corneal high-order aberrations according to the presence of subclinical corneal edema in Fuchs' endothelial corneal dystrophy using Scheimpflug topography.

All the patients underwent corneal topography (Sirius Scheimpflug-Placido disc camera; CSO Ophthalmic, Scandicci, Italy). Fifty-two eyes of 31 patients with Fuchs' endothelial corneal dystrophy and 52 eyes of 35 patients without corneal problems were included. In addition, patients with Fuchs' endothelial corneal dystrophy were divided into two groups according to subclinical corneal edema as with Fuchs' endothelial corneal dystrophy-edema and Fuchs' endothelial corneal dystrophy-nonedema. Subclinical corneal edema was defined based on the presence of at least two of three findings of the loss of regular isopachs, displacement of the thinnest point of the cornea, and posterior depression. High-order aberrations were expressed as Zernike polynomials in the 4- and 6-mm optical zone.

We found that subclinical corneal edema in Fuchs' endothelial corneal dystrophy caused a larger 4-mm trefoil II and a smaller 6-mm spherical aberration II measurements than the nonedema group. The 6-mm total high-order aberrations, 6-mm coma aberration, and 4- and 6-mm trefoil II aberration measurements were larger, and the 6-mm spherical aberration II was smaller in Fuchs' endothelial corneal dystrophy patients with edema compared with the healthy eyes.

The presence of subclinical corneal edema in Fuchs' endothelial corneal dystrophy results in larger 4-mm trefoil II and smaller 6-mm spherical aberration II measurements. More patients with intermediate values are needed to evaluate the effect of these aberrations on visual acuity.