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Using the posterior to anterior corneal curvature radii ratio to minimize the risk of a postoperative hyperopic shift after Descemet membrane endothelial keratoplasty

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Abstract

Purpose

To evaluate different corneal parameters in identifying patients at risk of a hyperopic shift after (DMEK).

Methods

This retrospective study included 92 eyes of patients with FECD after DMEK surgery. Pachymetry parameters, various tomographic parameters and densitometry values before and after DMEK were determined using a rotating Scheimpflug system (Pentacam HR, Oculus). For assessing the posterior to anterior corneal curvature relationship, we calculated the RPA (posterior to anterior corneal curvature radii ratio).

Results

The average keratometry reading of the posterior corneal surface (KmB) increased and the total corneal refractive power (TCRP) decreased significantly after surgery (P < .001). There was a significant difference between the preoperative and postoperative RPA (P < .001) and the posterior Q value (P < .001). The strongest correlation was found between the change in the KmB and the preoperative RPA (Spearman’s correlation coefficient = 0.872, P < .001). In the receiver operating characteristic (ROC) analysis, the highest AUC values (for ∆KmB) among the different preoperative parameters tested were obtained for RPA and posterior Q value (Asph. QB) with AUROC (area under the ROC) values of 0.95 and 0.89, respectively.

Conclusions

The Q value and the RPA showed the highest correlation with the change in corneal refractive power and the greatest AUC. These parameters could be used as surrogate markers to identify eyes that might be at risk of a greater postoperative hyperopic shift, which would allow more accurate setting of refractive goals.

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Authors and Affiliations

  1. Dept. of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany

    Raphael Diener, Nicole Eter & Maged Alnawaiseh

Authors
  1. Raphael Diener
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  2. Nicole Eter
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  3. Maged Alnawaiseh
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Correspondence to Maged Alnawaiseh.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The following authors have no financial disclosures: Maged Alnawaiseh, Raphael Diener, Nicole Eter.

Informed consent

This retrospective study was approved by the local Institutional Review Board (Ethics Committee of the WWU Muenster, Germany).

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Diener, R., Eter, N. & Alnawaiseh, M. Using the posterior to anterior corneal curvature radii ratio to minimize the risk of a postoperative hyperopic shift after Descemet membrane endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol 258, 1065–1071 (2020). https://doi.org/10.1007/s00417-019-04566-x

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  • DOI: https://doi.org/10.1007/s00417-019-04566-x

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