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					      Ocular Wavefront Aberrations after
      Descemet-Stripping with Endothelial
                Keratoplasty

                        Sanjay V. Patel, MD,
    Loren S. Seery, MD, Keith H. Baratz, MD, Jay W. McLaren, PhD

                       Department of Ophthalmology
                               Mayo Clinic
                          Rochester, Minnesota



Support: Research to Prevent Blindness, Inc., (unrestricted departmental grant, and
          SVP as Olga Keith Wiess Special Scholar); Mayo Foundation
                      Financial Interests: None (all authors)
                        Purpose

• To compare whole eye high-order aberrations (HOAs) between
  pseudophakic eyes at 6 and 12 months after DSEK and
  pseudophakic eyes that have normal corneas


• To determine relationships between HOAs and vision after
  DSEK
                              Methods
                         Cross-sectional Study

                            DSEK                                 Pseudophakic

n                 6 mo: 16 eyes (16 subjects)                 27 eyes (17 subjects)
                 12 mo: 17 eyes (17 subjects)

Age            6 mo: 65 ± 8 years (range, 53-77)          70 ± 7 years (range, 59-83)
              12 mo: 64 ± 11 years (range, 41-78)

Cornea            Clear graft (microkeratome                         Normal
                -prepared) for Fuchs’ dystrophy
                                                  Same type
Lens                  Non-aspheric IOL              of IOL
                                                                Non-aspheric IOL
                          No PCO                                    No PCO

Macula                     Normal                                    Normal

Optic nerve                Normal                                    Normal
                       Methods
                          Outcomes


• High-order aberrations (HOAs)
    • Measured by a Hartmann-Shack aberrometer
    • 3 mm pupil
    • Decomposed to Zernicke polynomials through 6th order

• Low-contrast visual acuity
    • More sensitive to changes in HOAs than high-contrast
      visual acuity
    • Best-corrected
    • 10%-contrast ETDRS chart
    • Photopic conditions (139 cd/m2)
                        Methods
                      Statistical Analysis


• Aberrations were compared between groups by using
  generalized estimating equation (GEE) models to account for
  any correlation between fellow eyes of the same subjects


• Significance of correlation was completed by GEE models
                        Results

• The aberrometer could not measure aberrations in

    • 5/16 eyes at 6 months after DSEK

    • 4/17 eyes at 12 months after DSEK
                      Conclusions

• Total HOAs (for the whole eye) are increased in pseudophakic eyes
  after DSEK compared to otherwise normal pseudophakic eyes
    • Trefoil was the dominant contributor to increased HOAs
    • The difference in HOAs can be attributed to the optical
       properties of the cornea after DSEK
    • Further study is required to determine the exact source of
       increased HOAs within the cornea


• Increased HOAs after DSEK might contribute to decreased vision

				
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posted:10/3/2012
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