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Effects of corneal irregular astigmatism on visual acuity after conventional and femtosecond laser-assisted Descemet’s stripping automated endothelial keratoplasty

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare short-term outcomes of Descemet’s stripping automated endothelial keratoplasty (DSAEK) using a graft prepared with either a femtosecond laser or a microkeratome.

Methods

Thirty-eight patients underwent DSAEK with grafts prepared with either a femtosecond laser (f-DSAEK; 21 eyes) or a microkeratome (m-DSAEK; 17 eyes). Visual acuity, endothelial cell density, regular astigmatism and irregular astigmatism were compared between the two groups preoperatively and at 1, 3, and 6 months post-operatively. Fourier analysis was conducted to calculate astigmatism of the anterior and posterior surfaces, and total cornea, using anterior segment optical coherence tomography (AS-OCT).

Results

Visual acuity (logMAR) improved from 1.20 ± 0.60 to 0.43 ± 0.25 after m-DSAEK (P < 0.001) and from 1.20 ± 0.57 to 0.77 ± 0.33 after f-DSAEK (P = 0.0028) at 6 months following DSAEK. Visual acuity after m-DSAEK was significantly better than after f-DSAEK at 1, 3, and 6 months (P < 0.05). AS-OCT corneal images revealed greater irregularities on the posterior surfaces of f-DSAEK grafts compared to m-DSAEK grafts. Irregular astigmatism of the total cornea and the posterior surface was significantly larger after f-DSAEK than after m-DSAEK, although there was no significant difference in irregular astigmatism of the anterior surface at 6 months. Postoperative visual acuity was significantly correlated with the postoperative irregular astigmatism of the total cornea (r = 0.6657 and P < 0.001) and the anterior (r = 0.416, P = 0.016) and posterior surfaces (r = 0.7046, P < 0.001).

Conclusions

Visual outcomes after f-DSAEK were poor compared to conventional m-DSAEK due to an increase in irregular astigmatism caused by posterior surface irregularities.

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Conflicts of interest

D. Tomida, None; T. Yamaguchi, None; A. Ogawa, None; Y. Hirayama, None; S. Shimazaki-Den, None; Y. Satake, None; J. Shimazaki, None.

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Authors and Affiliations

  1. Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan

    Daisuke Tomida, Takefumi Yamaguchi, Akiko Ogawa, Yumiko Hirayama, Seika Shimazaki-Den, Yoshiyuki Satake & Jun Shimazaki

  2. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan

    Takefumi Yamaguchi, Akiko Ogawa & Jun Shimazaki

Authors
  1. Daisuke Tomida
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  2. Takefumi Yamaguchi
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  3. Akiko Ogawa
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  4. Yumiko Hirayama
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  5. Seika Shimazaki-Den
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  6. Yoshiyuki Satake
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  7. Jun Shimazaki
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Correspondence to Takefumi Yamaguchi.

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Tomida, D., Yamaguchi, T., Ogawa, A. et al. Effects of corneal irregular astigmatism on visual acuity after conventional and femtosecond laser-assisted Descemet’s stripping automated endothelial keratoplasty. Jpn J Ophthalmol 59, 216–222 (2015). https://doi.org/10.1007/s10384-015-0388-y

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  • DOI: https://doi.org/10.1007/s10384-015-0388-y

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