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Visual outcome of penetrating keratoplasty, deep anterior lamellar keratoplasty
and Descemet membrane endothelial keratoplasty
#MMPMID29146479
Garrido C
; Cardona G
; Güell JL
; Pujol J
J Optom
2018[Jul]; 11
(3
): 174-181
PMID29146479
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PURPOSE: A single-center, cross-sectional study was designed to assess and
compare objective and subjective quality of vision of patients intervened with
penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and
Descemet membrane endothelial keratoplasty (DMEK). METHODS: Forty-six patients
previously intervened with PK (22 eyes), DALK (7 eyes) and DMEK (17 eyes) were
recruited. Visual evaluation included spherical and cylindrical refraction,
distance corrected visual acuity (DCVA), photopic contrast sensitivity (CS),
optical quality, measured with the HD Analyzer (objective scattering index [OSI],
MTF cut-off and Strehl ratio), and ocular and corneal aberrometry, measured with
the KR-1W Wavefront Analyzer. RESULTS: Statistically significant between-group
differences were found in age (p=0.006, DMEK patients were older) and time since
surgery (p<0.001, longest time for PK patients). No statistically significant
differences were found in DCVA between the techniques. Between-group differences
were encountered in CS at 12 (p=0.007) and 18 (p<0.001) cycles per degree, with
DMEK and DALK obtaining the best and worst outcomes, respectively. Differences in
optical quality were found between the techniques (OSI, p=0.004; MTF cut-off,
p=0.048; Strehl ratio p=0.022), with DMEK displaying the best outcomes. Highest
and lowest values in ocular and corneal aberrations were for DALK and DMEK
patients, respectively. Between-group differences were found in corneal
astigmatism (p<0.001; -3.31±2.00 D in PK; -2.68±0.94 D in DALK; -1.09±0.62 D in
DMEK). CONCLUSION: Overall, DMEK proved superior over PK and DALK in terms of
quality of vision, with PK offering slightly better outcomes than DALK in most
visual function parameters under evaluation.
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