Graft Thickness at 6 Months Postoperatively Predicts Long-Term Visual Acuity Outcomes of Descemet Stripping Automated Endothelial Keratoplasty for Fuchs Dystrophy and Moderate Phakic Bullous Keratopathy: A Cohort Study

Jean Marc Perone, Christophe Goetz, Yinka Zevering, Alexis Derumigny, Florian Bloch, Jean Charles Vermion, Louis Lhuillier

Research output: Contribution to journalArticleScientificpeer-review

2 Citations (Scopus)
21 Downloads (Pure)

Abstract

Purpose:It remains unclear whether preoperative central graft thickness (CGT) contributes to visual outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK). This retrospective cohort study examined the ability of preoperative and postoperative CGT to predict 12-month best spectacle-corrected visual acuity (BSCVA) after DSAEK for Fuchs endothelial corneal dystrophy/moderate pseudophakic bullous keratopathy/second graft.Methods:All consecutive patients who underwent DSAEK in 2015 to 2018 were included. The primary end point was 12-month BSCVA. DSAEK-CGT was measured preoperatively and 6 times between postoperative day 8 and month 12. Eyes were divided according to preoperative CGT 130 m (ultrathin-DSAEK threshold) or 6-month postoperative CGT 100 m (mean 6-month postoperative DSAEK-CGT). The t test assessed CGT evolution of the 4 groups over time. Multivariate analyses examined whether preoperative CGT or 6-month CGT categories predicted 12-month BSCVA. Multivariate analysis assessed the preoperative/perioperative factors that predicted 6-month CGT.Results:A total of 108 eyes (68 patients) underwent DSAEK. Preoperative CGT was >130 and ≤130 m in 87 and 21 eyes, respectively. Postoperative CGT was >100 and ≤100 m in 50 and 58 eyes, respectively. Thin 6-month postoperative grafts thinned significantly more relative to preoperative thickness than thick grafts (P < 0.001). Preoperative CGT subgroups did not show this difference. Six-month postoperative CGT (P = 0.01), but not preoperative CGT, predicted 12-month BSCVA. Preoperative CGT strongly predicted 6-month CGT (P = 0.0003).Conclusions:Postoperative, but not preoperative, DSAEK-CGT predicted 6-month BSCVA. The correlation between preoperative and postoperative CGT and interstudy variation in preoperative CGT measurement accuracy may explain literature disparities regarding the importance of preoperative CGT in DSAEK outcomes.

Original languageEnglish
Pages (from-to)1362-1371
Number of pages10
JournalCornea
Volume41
Issue number11
DOIs
Publication statusPublished - 2022

Bibliographical note

Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care

Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.

Keywords

  • DSAEK
  • central graft thickness
  • visual acuity
  • Fuchs endothelial corneal dystrophy

Fingerprint

Dive into the research topics of 'Graft Thickness at 6 Months Postoperatively Predicts Long-Term Visual Acuity Outcomes of Descemet Stripping Automated Endothelial Keratoplasty for Fuchs Dystrophy and Moderate Phakic Bullous Keratopathy: A Cohort Study'. Together they form a unique fingerprint.

Cite this