Document Detail


Refractive change and stability after Descemet membrane endothelial keratoplasty Effect of corneal dehydration-induced hyperopic shift on intraocular lens power calculation.
MedLine Citation:
PMID:  21782088     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To determine the refractive change and stability of the transplanted cornea after Descemet membrane endothelial keratoplasty (DMEK) through a 3.0 mm clear corneal incision.
SETTING: Tertiary referral center.
DESIGN: Cohort study.
METHODS: Subjective and objective refractive data from pseudophakic eyes were obtained before and 3 and 6 months after DMEK.
RESULTS: The study comprised 50 eyes, 7 were phakic and 43 pseudophakic. Six months postoperatively, the corrected distance visual acuity was 20/25 (0.8) or better in 38 eyes (74%). The mean increase in spherical equivalent at 6 months (N = 50) was +0.32 diopter (D) ± 1.01 D (SD) (P=.0304) and in refractive cylinder, -0.48 ± 1.02 D (P=.001). Although Scheimpflug imaging showed a stable anterior corneal curvature, the posterior curvature increased from 5.50 ± 0.5 D preoperatively to 6.40 ± 0.4 D at 6 months and pachymetry decreased from 672 ± 82 μm to 540 ± 59 μm, respectively (both N = 32) (both P=.000).
CONCLUSIONS: After DMEK, a slight preoperative to postoperative refractive change and stabilization at 3 months occurred that may induce a hyperopic shift that was not the result of the negative lenticule effect of DSEK/DSAEK. Thus, in DMEK, the hyperopic shift may result from a reversal of a preceding myopic shift induced by stromal swelling in endothelial disease. If so, normal intraocular power nomograms apply for cataract surgery before or during DMEK.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
Authors:
Lisanne Ham; Isabel Dapena; Kyros Moutsouris; Chandra Balachandran; Laurence E Frank; Korine van Dijk; Gerrit R J Melles
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  37     ISSN:  1873-4502     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1455-64     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Affiliation:
From the Netherlands Institute for Innovative Ocular Surgery (Ham, Dapena, Moutsouris, Balachandran, van Dijk, Melles), Melles Cornea Clinic (Ham, Dapena, Moutsouris, Balachandran, van Dijk, Melles), Amnitrans Eye Bank (Ham, Melles), Rotterdam, and Department of Methodology and Statistics (Frank), Utrecht University, Utrecht, The Netherlands.
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