Descemet stripping automated endothelial keratoplasty in Fuchs' corneal endothelial dystrophy: Anterior segment optical coherence tomography and in vivo confocal microscopy analysis

Abstract

Background: To evaluate the in vivo corneal changes using in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) in patients with Fuchs' dystrophy who underwent Descemet stripping automated endothelial keratoplasty (DSAEK) and the relationship between these changes and the postoperative visual recovery up to 1-year follow-up. Methods: Before DSAEK and 1 day, 3, 6 and 12 months after surgery 31 patients (39 pseudophakic eyes) underwent a complete ophthalmological evaluation including best corrected visual acuity (BCVA), IVCM (subepithelial haze, interface haze, graft thickness) and AS-OCT (graft thickness). Results: Graft thickness measurements by AS-OCT were strongly correlated to those obtained using IVCM at every follow-up stage (intraclass correlation coefficientâ\u88\u88=â\u88\u880.95 to 0.97 between 3 and 12 months, Pâ\u88\u88<â\u88\u880.001 for all coefficients). No correlation between BCVA and graft thickness measured by AS-OCT at any follow-up stage was found, while at 3 and 6 postoperative months the correlations between BCVA and preoperative subepithelial haze (râ\u88\u88=â\u88\u880.61, Pâ\u88\u88<â\u88\u880.001 and râ\u88\u88=â\u88\u880.46, Pâ\u88\u88=â\u88\u880.002), interface haze (râ\u88\u88=â\u88\u880.51, Pâ\u88\u88<â\u88\u880.001 and râ\u88\u88=â\u88\u880.46, Pâ\u88\u88=â\u88\u880.003), postoperative subepithelial haze (râ\u88\u88=â\u88\u880.43, Pâ\u88\u88=â\u88\u880.004 and râ\u88\u88=â\u88\u880.39, Pâ\u88\u88=â\u88\u880.001) were significant. Conclusions: The study confirmed corneal subepithelial haze and interface haze as important factors limiting visual acuity after DSAEK, while graft thickness was not related to BCVA