Relationship between donor–receptor interface and visual acuity in DSAEK☆

Abstract Objective To evaluate the relationship between best corrected visual acuity and donor–recipient interface resulting after Descemet's Stripping with Automated Endothelial Keratoplasty (DSAEK). Methods Retrospective review of 46 clinical histories after DSAEK intervention in which 22 patients who fulfilled the inclusion criteria (two with bilateral DSAEK), were studied. All were operated on by the same ophthalmologist from January 2010 until April 2011. Surgical indications were: 19 (72.2%) bullous keratopathy, 3 (12.5%) Fuchs endothelial dystrophy, and 2 (8.3%) previous failed keratoplasty. The visual acuity (VA) was recorded preoperatively, and at 3 and 6 months after the operation; the latter two were being compared with the interface between donor and recipient after DSAEK measured in a Scheimpflug corneal topography camera (Pentacam ® model). Results After DSAEK surgery 19 eyes had improved visual acuity at 3 months, and 20 eyes at 6 months ( P p p  = .045). Also, patients who had a denser stroma had a worse postoperative visual acuity in relative terms when compared with those who had a less damaged stroma. Conclusions Patients undergoing DSAEK with worse preoperative visual acuity had a greater improvement visual in absolute values and however, they may have achieved a lower relative visual acuity than could be related to a higher refractive interface, as a result of a more damaged preoperative corneal stroma.