Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
+44 1223 790975
ISSN: 2155-9570
+44 1223 790975
Divya Srikumaran, Hyeck-Soo Son, Jefferson J Doyle, Beatriz Muñoz, Walter J Stark, Russell L McCally and Albert S Jun
Purpose: To assess a potential relationship between visual acuity and corneal haze and thickness after Descemet Stripping Endothelial Keratoplasty (DSEK).
Methods: Retrospective review of patients who underwent DSEK surgery with at least 3 months of post-operative follow up. Best-spectacle corrected visual acuity (BSCVA) and ultrasonic pachymetry were measured, and a Pentacam scan was performed for each study eye. Pentacam images were analyzed to determine the surface, host stromal, interface, and graft light scattering levels, which were used as markers of corneal haze. The central donor graft and overall central thicknesses were also measured from the Pentacam. Pearson correlation coefficients were calculated for each of the parameters and post-operative BSCVA to identify any potential associations. A multivariate analysis was performed using a linear regression model predicting visual acuity for each of the significant parameters from the univariate analysis adjusting for patient age and pre-operative acuity.
Results: Results are reported for 41 eyes of 36 patients. Pearson correlation coefficients showed a statistically significant positive correlation between post-operative BSCVA and age (r=0.36, P=0.020), interface-stromal scattering (r=0.44, P=0.004), and interface-graft scattering (r=0.36, P=0.022). No correlation was found between BSCVA and surface scattering (r=0.04, P=0.78), host stromal scattering (r=-0.15, P=0.35), mean interface scattering (r=0.18, P=0.25), or graft scattering (r=-0.14, P=0.38). A trend towards a positive correlation between BSCVA and central donor graft thickness was noted on the exploratory scatter plot but this was not statistically significant (r=0.27, P=0.085). A linear regression analysis controlling for age and pre-operative acuity was performed for the above parameters and the correlation between BSCVA and the difference between interface and host stromal scattering remained statistically significant (β=0.00375, P=0.0195).
Conclusion: Eyes with better BSCVA after DSEK tend to have lower differences between interface and stromal light scattering. However, no relationship was found between BSCVA and the other measures of corneal light scattering or corneal thickness. Additional prospective studies using techniques such as in vivo confocal microscopy to supplement the present methods could be performed to validate the relative impact of regional differences in corneal haze on visual acuity outcomes after DSEK.