ABSTRACT
Objective To evaluate the relationship, over time, between central graft thickness and visual acuity following Descemet's stripping endothelial keratoplasty (DSEK). Methods A retrospective analysis of 70 consecutive cases of DSEK. All donor lenticules were dissected manually. Serial postoperative measurements of central graft and total corneal thicknesses were made using anterior segment optical coherence tomography. Visual acuity, refraction and patient demographics were collected from case notes. The correlation between central graft thickness and visual acuity at serial time points was calculated. Results The median age at surgery was 75 years (lower quartile (LQ) 66, upper quartile (UQ) 83, range 36-90 years). Nineteen eyes were excluded from statistical analysis, leaving 51 eyes of 46 patients remaining. Last follow-up occurred a median of 12 months postoperatively (LQ 6, UQ 23, range 4-38 months). The median preoperative visual acuity was 0.71 logarithm of the minimum angle of resolution (logMAR), improving to 0.34 logMAR postoperatively (p<0.001, n=43). Median graft thickness decreased from 209 µm at day 1 to 142 µm at last follow-up (p<0.001). No statistically significant correlation was found between central total corneal thickness and visual acuity at any time point. Except for a single time point, no statistically significant correlation was found between central graft thickness and visual acuity. Conclusion There is no clear association between central graft, or total corneal, thickness and visual acuity following DSEK.
Subject(s)
Cornea/pathology , Corneal Dystrophies, Hereditary/surgery , Descemet Stripping Endothelial Keratoplasty , Endothelium, Corneal/pathology , Visual Acuity/physiology , Adult , Aged , Aged, 80 and over , Corneal Dystrophies, Hereditary/physiopathology , Female , Humans , Male , Middle Aged , Refraction, Ocular/physiology , Retrospective Studies , Tissue Donors , Tomography, Optical CoherenceABSTRACT
PURPOSE: To discuss the initial results of fitting SynergEyes hybrid contact lenses (SynergEyes, Inc, Carlsbad, CA) for keratoconus (KC) and pellucid marginal degeneration (PMD). METHODS: The charts of patients fit with SynergEyes lenses during the first 7 months the lens was available on the Cornea Service at Wills Eye Institute (August 3, 2006 to March 5, 2007) were retrospectively reviewed. RESULTS: Sixty-one eyes (44 patients) with KC (58 eyes) or PMD (3 eyes) were fit with SynergEyes hybrid contacts. The mean age was 40 +/- 12.6 years; the mean follow-up period was 7.8 +/- 4.6 months. The most common indication for SynergEyes was rigid gas permeable (RGP) lens intolerance, 31 of 61 eyes (50.8%). Inability to fit with RGP was the indication in 8 eyes (13.1%), and 22 eyes (36%) were refit from SoftPerm (Ciba Vision, Corp, Duluth, GA). Twenty-two patients required refitting, including 17 base curve changes and 5 skirt changes. The success rate was 86.9% (53 of 61 eyes). Most failures (8 eyes of 6 patients) discontinued the lens within the first 1-2 months because of discomfort (5 eyes) or unsatisfactory vision (3 eyes). CONCLUSION: SynergEyes lenses are a promising alternative for visual rehabilitation in patients with KC and PMD who are intolerant or unable to be fit in RGP lenses.
