In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions
Majid Moshirfar, Monette T Lependu, Dane Church, Marcus C Neuffer
John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
Introduction: Descemet’s stripping automated endothelial keratoplasty (DSAEK) venting incisions may induce irregular corneal astigmatism. The study examines in vivo and in vitro astigmatic effects of venting incisions.
Patients and methods: In vivo analysis examined eleven eyes of eleven patients who had received DSAEK with venting incisions. A chart review of the eleven eyes including assessment of pre and postoperative refraction and topography was performed. In vitro analysis examined three cadaver eyes which received topographic imaging followed by venting incisions at 4 mm, 6 mm, and 7 mm optical zones. Topographic imaging was then performed again after the incisions.
Results: Postoperative topographies of eleven eyes demonstrated localized flattening at incision sites and cloverleaf pattern astigmatism. There was a significant difference in corneal irregularity measurement (P = 0.03), but no significant difference in shape factor or change of topographic cylinder. The cloverleaf pattern was found in cadaver eyes with incisions placed at 4 mm and 6 mm optical zones but not at the 7 mm zone.
Conclusion: DSAEK venting incisions can cause irregular corneal astigmatism that may affect visual outcomes. The authors recommend placement of venting incisions near the 7 mm optical zone.
Keywords: DSAEK, venting incisions, endothelial keratoplasty, astigmatism, endothelium, endothelial transplant
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]