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Impact of DSEK on Topography and Axial Length: Analyzing Refractive Error Changes

jaclyn avatar
jaclyn
7 diapositives · 198 Views · Sep 07, 2014

This study evaluates the changes in keratometry, pachymetry, and axial length following Descemet’s Stripping Endothelial Keratoplasty (DSEK), focusing on their correlation with induced refractive errors. The findings indicate an average hyperopic shift of 1.3D and an average flattening of keratometry by 0.5D post-operatively. Although no significant change was observed in axial length or keratometry between the DSEK and contralateral eye, a trend suggests that corneal flattening may contribute to the common hyperopic shift noted after DSEK.

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  1. Topographic and Axial Length Changes after Descemet’s Stripping Endothelial Keratoplasty:  The effect on refractive error John P Berdahl M.D.* David R. Hardten M.D. , F.A.C.S.* *No relevant financial disclosures

  2. Background • Descemet’s Stripping Endothelial Keratoplasty (DSEK) is known to cause a hyperopic shift. • The hyperopic shift has been attributed to the divergent refractive property of the DSEK lenticule itself. • Other factors such as keratometry and axial length could also contribute. Purpose • To evaluate if keratometry changes are caused by DSEK and if changes correlate with induced refractive error

  3. Methods • Comparisons Comparison to contralateral eye • Keratomety (Manual or Topo) • Pachymetry • Axial length (if present) Comparison of DSEK eye (pre and post-op) • Change in Keratomety • Change in Pachymetry • Change in Visual acuity • Change in refraction from prediction* *Predicted post-op refraction was based on IOL calculations in patients with combined cataract surgery. *Predicted post-op refraction was identical to pre-op refraction in patients undergoing DSEK only

  4. Results • Average age - 60 • 10 Males, 10 Females • Average f/u time 287 days • No significant change in axial length (only measured in 2 patients) • No significant difference in pre-op or post-op Keratometry was observed when comparing DSEK eye to contralateral eye.

  5. Results Average change from predicted refractive error was 1.3D more hyperopic Average keratometry flattens by -0.52D (p<0.05) steeper flatter Pre-op Post-op No correlation between change in K’s from DSEK and change from predicted refraction

  6. Summary • A hyperopic shift of 1.3D is created by DSEK • Average K’s flatten by 0.5D after DSEK (p<0.5) • Flattening of keratometry was not statistically significantly correlated with the amount of induced hyperopia. However, a trend was observed since most eyes become flatter and more hyperopic. Pre-op Average K 43.5D POM #11 Average K 42.31D POM #4 Average K 42.12D

  7. Conclusions • Corneal flattening may contribute the hyperopic shift commonly observed after DSEK.