Corneal Higher-Order Aberrations after Descemet's Stripping Automated Endothelial Keratoplasty

Purpose: To compare the corneal higher-order aberration (HOA) after Descemet's stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP), and in age-matched controls. Design: Cross-sectional, non-comparative interventional case series. Participants: Thirty-one eyes of 28 patients who underwent DSAEK, 20 eyes of 16 patients who underwent PKP, and 31 eyes of 31 control patients. Intervention: The corneal topography and HOAs of the central 4- and 6-mm zones from anterior and posterior corneal surfaces were evaluated postoperatively with the Scheimpflug rotating imaging system (Oculus Gmbh, Wetzlar, Germany). Main Outcome Measures: Anterior and posterior corneal HOAs. Results: The mean anterior corneal total HOAs of the central 4 and 6 mm were 0.599±0.288 μm and 1.215±0.496 μm, respectively, in eyes that underwent DSAEK; 1.730±0.826 μm and 3.349±1.490 μm, respectively, in eyes that underwent PKP; and 0.439±0.163 μm and 0.921±0.300 μm, respectively, in controls. Although the mean anterior corneal total HOAs of the central 4 and 6 mm were significantly higher in eyes that underwent PKP than in eyes that underwent DSAEK and in controls (P<0.01), there was no significant difference in anterior corneal total HOAs of the central 4 and 6 mm between eyes that underwent DSAEK and controls. The mean posterior corneal total HOAs of the central 4 and 6 mm were 3.680±1.586 μm and 7.142±3.011 μm, respectively, in eyes that underwent DSAEK; 2.957±1.238 μm and 5.314±2.095 μm, respectively, in eyes that underwent PKP; and 0.818±0.193 μm and 1.609±0.344 μm, respectively, in controls. Although there was no significant difference in posterior corneal total HOAs of the central 4 mm between the DSAEK group and the PKP group, the posterior corneal HOAs of the central 6 mm were significantly higher in the DSAEK group than in the PKP group (P<0.01). Conclusions: Although posterior corneal HOAs are significantly higher in eyes that underwent DSAEK, anterior corneal HOAs are not significantly different in eyes that underwent DSAEK than those of age-matched controls. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.