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Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts

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Recurrent Keratoconus: Corneal Transplants for Keratoconus Develop Tomographic Ectatic Changes.

Maria Miura^1,2, Pia Leon¹, Yoav Nahum^3,4

¹Schepens Eye Research Institution, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA.

|February 2, 2023

Summary

This summary is machine-generated.

Postoperative ectasia indicative changes were observed in corneal grafts within 5 years after penetrating keratoplasty (PK) for keratoconus (KC). Larger host trephination size correlated with less Kmax progression.

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Area of Science:

Ophthalmology
Corneal Surgery
Biomedical Imaging

Background:

Keratoconus (KC) is a progressive thinning disorder of the cornea.
Penetrating keratoplasty (PK) is a surgical option for advanced KC.
Long-term graft stability after PK in KC patients requires further investigation.

Purpose of the Study:

To evaluate Scheimpflug imaging changes in corneal grafts up to 5 years post-PK in KC patients.
To identify tomographic signs of ectasia progression in grafts.
To explore correlations between graft changes and surgical parameters.

Main Methods:

Retrospective analysis of 31 eyes undergoing first PK for KC.
Serial Scheimpflug imaging (Pentacam HR) at baseline, 3, and 5 years post-PK.
Analysis of maximal keratometry (Kmax), anterior/posterior best fit sphere, and host trephine size.

Main Results:

Significant progression in Kmax (average increase of 5.3D by year 5) and best fit sphere parameters observed.
74.2% of patients showed Kmax increase ≥2D; 25.8% showed ≥7D increase.
Larger host trephine size inversely correlated with Kmax progression (r = -0.52, P = 0.01).

Conclusions:

Corneal grafts show tomographic changes indicative of ectasia 3-5 years after PK in KC patients.
These graft changes occur sooner and more frequently than previously reported.
Host trephine size is a potential factor influencing graft stability post-PK.