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Evaluation of different preoperative parameters for minimizing the risk for postoperative hyperopic shift after Descemet membrane endothelial keratoplasty in patients with Fuchs' endothelial corneal dystrophy

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First Author: M.Alnawaiseh GERMANY

Co Author(s):    R. Diener   N. Eter                 

Abstract Details

Purpose:

To evaluate different corneal parameters in identifying patients at risk of a hyperopic shift after Descemet membrane endothelial keratoplasty (DMEK)

Setting:

Retrospective cohort study

Methods:

This retrospective study included 92 eyes of patients with FECD after DMEK surgery. Pachymetry parameters, various topographic parameters and densitometry values before and after DMEK were determined using a rotating Scheimpflug system (Pentacam HR, Oculus) and then analyzed.For assessing the posterior to anterior corneal curvature relationship, we calculated the RPA (posterior to anterior corneal curvature radii ratio). Receiver-operating characteristic curve (ROC) analysis was performed and the Youden Index for each parameter calculated to determine its critical threshold value.

Results:

The KmB increased and the TCRP decreased significantly after surgery (P < .001). There was a significant difference between the preoperative and postoperative RPA (P >0.001) and the posterior Q value (P >0.001). The strongest correlation was found between the change in the KmB and the preoperative RPA (Spearman’s correlation coefficient = 0.869, P >0.001). 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:

Taking patients’ preoperative RPA and posterior Q value measurements into consideration would help to identify those at the greatest risk of a postoperative hyperopic shift, which would allow more accurate setting of refractive goals and minimize the risk of a postoperative hyperopic surprise.

Financial Disclosure:

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