Posters

Evaluation of certain preoperative parameters to minimise the risk of a postoperative hyperopic shift after Descemet's membrane endothelial keratoplasty in patients with Fuchs' endothelial corneal dystrophy (FECD)

Poster Details

First Author: M.Alnawaiseh GERMANY

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

Abstract Details

Purpose:

We evaluated the correlation between the change in total corneal refractive power (TCRP) and the refractive shift at the posterior corneal surface (KmB) with different corneal parameters and the ability of certain preoperative parameters to identify patients at risk of a hyperopic shift after Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Dept. of Ophthalmology, University of Muenster Medical Center

Methods:

This retrospective study included 92 eyes of patients with FECD (age 70 ± 10 years) 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 after DMEK, 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 (<0.001). There was also 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:

None