Two-Year Course of Corneal Densitometry after Descemet membrane endothelial keratoplasty (DMEK)

• Published in: American journal of ophthalmology 2017-03, Vol.175, p.60-67
• Main Authors: Schaub, Friederike, Enders, Philip, Bluhm, Cornelius, Bachmann, Björn O, Cursiefen, Claus, Heindl, Ludwig M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Colleges & universities; Cornea; Cornea - diagnostic imaging; Cornea - surgery; Corneal Pachymetry - methods; Densitometry - methods; Descemet Stripping Endothelial Keratoplasty - methods; Female; Follow-Up Studies; Fuchs' Endothelial Dystrophy - diagnosis; Fuchs' Endothelial Dystrophy - surgery; Glaucoma; Humans; Light; Male; Middle Aged; Ophthalmology; Postoperative Period; Reproducibility of Results; Retrospective Studies; Standard deviation; Surgery; Time Factors; Transplants & implants; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2016.11.019

Abstract Purpose To investigate the two-year course of corneal densitometry following Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy (FED). Design Retrospective, interventional case series. Methods Densitometry values (corneal light backscatter in greyscale units) measured by Scheimpflug-based imaging and clinical records of 160 eyes of 160 patients undergoing DMEK for FED were reviewed. Outcome measures included densitometry data in 4 corneal layers (anterior layer (AL), central layer (CL), posterior layer (PL), and total layer (TL)) and 2 annuli (central annular zone 0-2mm and peripheral zone 2-10mm), central corneal thickness (CCT), best spectacle-corrected visual acuity (BSCVA), and endothelial cell density (ECD) prior to DMEK and at 1, 3, 6, 12, and 24 months postoperatively. Results Corneal densitometry decreased in all 4 layers over 2 years following DMEK surgery. Regarding TL 0-2mm, the reduction of corneal light backscatter was statistically significant for all follow-up time points compared to preoperative values ( P < .001) and compared in-between follow-up periods ( P ≤ .010). Corneal light backscatter reduction was significantly higher in the center (0–2mm) than in the periphery (2-10mm) for all layers at 12 and 24 months ( P ≤ .002). ECD and CCT did not correlate with corneal densitometry, whereas BSCVA correlated moderately for TL 0–2 mm ( P = .026; r= .449) and TL 2–10mm ( P = .001; r= .585) at 12 months. Conclusions Corneal light backscatter show a significant reduction following DMEK surgery in Fuchs endothelial dystrophy over a period of 2 years, more pronounced in the corneal center, apparently in association with visual acuity improvement.