DSAEK linked to corneal changes that induce hyperopic shift

Investigators used the Pentacam rotating Scheimpflug camera to measure the corneal curvature and anterior segment parameters of nine patients before and after Descemet stripping automated endothelial keratoplasty (DSAEK). At three months follow up, DSAEK significantly increased posterior corneal k-reading, posterior corneal astigmatism, and corneal volume, resulting in a mild hyperopic shift. Anterior chamber angle, depth and volume did not change significantly.

Preoperative CCT decreased from 687 ± 85 microns to 631 ± 68 microns at three months after surgery (p = 0.07). Anterior mean K reading of the cornea flattened from 43.3 ± 1.65 D before surgery to 42.7 ± 1.5 D at three months (p = 0.03). Anterior corneal astigmatism did not change significantly. Posterior mean K reading of the cornea steepened significantly from -5.6 ± 0.6 D preoperatively to -7.2 ± 0.4 D at three months (p = 0.007). Posterior corneal astigmatism increased accordingly from 0.52 ± 0.17 D before surgery to 0.95 ± 0.57 D at three months (p = 0.07). CV increased significantly from 65.8 ± 5.6 µl before surgery to 85.2 ± 4.2 µl at 3 months (p = 0.007). ACA, ACD, and ACV did not change significantly following DSAEK surgery. The average postoperative spherical equivalent changed from 0.5 ± 2.5 D before surgery to 1.41 ± 0.59 D three months after surgery (p = 0.05).

The authors conclude that these results should be taken into consideration when performing a triple procedure.