TY - JOUR
T1 - Changes in Corneal Power up to 2 Years After Endothelial Keratoplasty
T2 - Results From the Randomized Controlled Descemet Endothelial Thickness Comparison Trial
AU - Chamberlain, Winston
AU - Shen, Elizabeth
AU - Werner, Samuel
AU - Lin, Charles
AU - Rose-Nussbaumer, Jennifer
N1 - Funding Information:
Funding/Support: This work was supported by Grants K23 EY025025 (J.R.-N.) and P30 EY010572 (Casey Eye Institute) from the National Eye Institute and unrestricted grant from Research to Prevent Blindness (Casey Eye Institute and Francis I. Proctor Foundation). These sources of funding were not involved in the study design, data collection or analysis, writing of the report, or the decision to submit this article. Financial Disclosures: The authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship. Author Contributions: Conception and design: W.C.; Analysis and interpretation: W.C., E.S., C.L., J.R.-N.; Writing the article: W.C., E.S.; Critical revision of the article: W.C.; Final approval of the article: W.C., E.S., S.W., C.L., J.R.-N.; Data Collection: W.C., S.W.; Provision of materials, patients, or resources: W.C.; Statistical expertise: W.C., E.S.; Obtaining funding: W.C.; Literature search: W.C., E.S.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1
Y1 - 2023/1
N2 - Purpose: To compare changes in corneal power measurements after Descemet membrane endothelial keratoplasty (DMEK) vs ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). Design: Post hoc subanalysis of the randomized controlled Descemet Endothelial Thickness Comparison Trial. Methods: A total of 50 eyes (38 patients) with endothelial dysfunction from Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy were randomized to DMEK or UT-DSAEK 1 to 2 days before surgery. Total corneal refractive power (TCRP) and anterior/posterior simulated keratometry were obtained using Scheimpflug imaging preoperatively (baseline) and postoperatively at 3, 6, 12, and 24 months. Spectacle refractions were performed at 6, 12, and 24 months after surgery. Setting: Hospital centers. Results: The mean hyperopic shift of TCRP from baseline to 12 months was 0.80 ± 1.1 (P = .002) in the DMEK group and 0.69 ± 0.84 (P < .001) in the UT-DSAEK group. Posterior corneal curvature (average K from simulated keratometry) steepened (more negative dioptric power) by 0.42 ± 0.10 (P < .001) in DMEK and 0.54 ± 0.09 (P < .001) in UT-DSAEK. The mean change in TCRP and posterior corneal curvature did not differ between DMEK and UT-DSAEK (TCRP, P = .71; posterior average K from simulated keratometry, P = .36). Conclusions: Sustained steepening in posterior corneal curvature with loss in total corneal power contributes to hyperopic shifts after endothelial keratoplasty. Changes in corneal measurements do not differ between DMEK and UT-DSAEK. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
AB - Purpose: To compare changes in corneal power measurements after Descemet membrane endothelial keratoplasty (DMEK) vs ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). Design: Post hoc subanalysis of the randomized controlled Descemet Endothelial Thickness Comparison Trial. Methods: A total of 50 eyes (38 patients) with endothelial dysfunction from Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy were randomized to DMEK or UT-DSAEK 1 to 2 days before surgery. Total corneal refractive power (TCRP) and anterior/posterior simulated keratometry were obtained using Scheimpflug imaging preoperatively (baseline) and postoperatively at 3, 6, 12, and 24 months. Spectacle refractions were performed at 6, 12, and 24 months after surgery. Setting: Hospital centers. Results: The mean hyperopic shift of TCRP from baseline to 12 months was 0.80 ± 1.1 (P = .002) in the DMEK group and 0.69 ± 0.84 (P < .001) in the UT-DSAEK group. Posterior corneal curvature (average K from simulated keratometry) steepened (more negative dioptric power) by 0.42 ± 0.10 (P < .001) in DMEK and 0.54 ± 0.09 (P < .001) in UT-DSAEK. The mean change in TCRP and posterior corneal curvature did not differ between DMEK and UT-DSAEK (TCRP, P = .71; posterior average K from simulated keratometry, P = .36). Conclusions: Sustained steepening in posterior corneal curvature with loss in total corneal power contributes to hyperopic shifts after endothelial keratoplasty. Changes in corneal measurements do not differ between DMEK and UT-DSAEK. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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U2 - 10.1016/j.ajo.2022.07.009
DO - 10.1016/j.ajo.2022.07.009
M3 - Article
C2 - 35870491
AN - SCOPUS:85141310723
SN - 0002-9394
VL - 245
SP - 233
EP - 241
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -