Comparative analysis of total ocular aberrations and posterior corneal surface metrics following ultra-thin manual Descemet’s striping endothelial keratoplasty.

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Presentation transcript:

Comparative analysis of total ocular aberrations and posterior corneal surface metrics following ultra-thin manual Descemet’s striping endothelial keratoplasty (UTMDSEK): A pilot study. ESCRS Congress Sep 2014 1st Author: Taha Y. Ahmed Co-Authors: Aris Konstantopoulos, Mohammed Rashid, Andrew Luff, Nina Attridge, Parwez N. Hossain &David F. Anderson Setting: University Hospital Southampton NHS foundation trust and Optegra Solent Hospital, Hampshire, UK Declaration: No financial interests

Descriptive statistics for aberrations and topography. n= 14 Measure Mean Std Dev Min Max RMS (mm) 3.35 .34 2.63 3.80 Total aberrations (µ) .70 .23 .33 1.11 LO Total (µ) .62 .28 1.03 Defocus (µ) .26 .38 -.51 .80 Astigmatism (µ) .42 .24 .04 .91 HO Total (µ) .30 .11 .14 .53 Coma (µ) .15 .10 .01 .31 Spherical (µ) .07 -.06 .21 Secondary Astigmatism (µ) .09 .02 Trefoil (µ) .05 .25 Sagital curvature 6.17 .55 5.00 6.96 KPD= 1.74 .90 2.80 True net power 40.31 1.84 37.00 42.00 True net power = addition of refractive values of anterior and posterior corneal surfaces. KPD= Keratometric power deviation map gives the difference at each point between the true net power map and the sagittal power map of the anterior corneal surface.

Beta, p and partial eta squared values for the multivariate multiple regression analysis Predictor: True net power Predictor: KPD

Results I Mean preoperative monocular BCVA was 0.50±0.18 logMAR. Graft thickness was 116μm±58.0 Mean follow up: 27.08 months, range (8-46 months). The mean preoperative MRSE was +0.81 D±3.03. At last follow up, the mean postoperative MRSE was -0.15 D±1.32. The mean postoperative monocular BCVA was 0.23±0.15 logMAR

Results II A significant positive relationship between KPD* and Coma, r(14) = 0.535, p = .049 A marginally significant negative relationship between KPD and Astigmatism, r(14)=-0.530, p = 0.051.

Conclusion In normal corneas its widely known; posterior corneal surface aberrations neutralize most of anterior corneal surface aberrations, the posterior corneal surface influence is best represented in topographic terms by Keratometric Power Deviation(KPD). This critical interaction is compromised in DSEK patients, due to the lenticule and loss of parallelism between anterior and posterior corneal surfaces. This compromised interaction was seen in our cohort as every patient demonstrated topographically a trend of higher KPD values than normal >0.75, which correlated significantly with higher coma aberrations. Posterior corneal surface optics are of paramount importance in endothelial keratoplasty outcomes.