Machalińska Anna, Kuligowska Agnieszka, Kaleta Karolina, Kuśmierz-Wojtasik Monika, Safranow Krzysztof
First Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland.
Faculty of Graphics, Academy of Art, Szczecin, Poland.
J Ophthalmol. 2021 Jul 21;2021:3055722. doi: 10.1155/2021/3055722. eCollection 2021.
To assess the time course changes in corneal topographic parameters during the one-year follow-up after Descemet membrane endothelial keratoplasty (DMEK) surgery.
Twenty-one patients (24 eyes) who underwent DMEK surgery were evaluated. Best corrected visual acuity (BCVA), endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA), and higher-order aberration (HOA) were assessed at baseline and 1, 3, 6 and 12 months after the surgery using CASIA2 anterior segment swept-source OCT (Tomey, Japan).
In patients who underwent DMEK surgery, BCVA improved gradually at the subsequent visits during the 12-month follow-up. A significant reduction in ECC and CCT at the 1st month was noted, which remained stable until the 6th month postoperatively. Anterior and total MK values remained unchanged, whereas changes in posterior keratometry were noticeable until the 6th month after surgery. A significant reduction in the anterior, posterior, and total astigmatism magnitude as well as astigmatism asymmetry was observed during the first 6 months after surgery. A gradual anterior, posterior, and total HOA decrease was documented until the 12th month after surgery. Negative correlations between baseline values of CCT, MK, MA, AA, and HOA and postoperative variations in those parameters at consecutive follow-up time points were observed. Accordingly, negative correlations between baseline CCT and postoperative changes in corneal topographic parameters after surgery were found.
The stabilization of most corneal topographic parameters takes place within 6 months after the procedure, whereas HOA reduction and BCVA improvement gradually occur during the first year after surgery. Preoperative values of corneal topographic parameters strongly determine their changes detected after DMEK surgery, which may suggest that early therapeutic intervention results in better visual outcomes.
评估深板层角膜内皮移植术（DMEK）术后一年随访期间角膜地形图参数的时间进程变化。
对21例行DMEK手术的患者（24只眼）进行评估。使用CASIA2眼前节扫频源光学相干断层扫描（日本拓普康公司）在基线时以及术后1、3、6和12个月评估最佳矫正视力（BCVA）、内皮细胞计数（ECC）、中央角膜厚度（CCT）、平均角膜曲率（MK）、平均散光（MA）、散光不对称性（AA）和高阶像差（HOA）。
行DMEK手术的患者，在12个月随访期间，后续各次就诊时BCVA逐渐改善。术后第1个月ECC和CCT显著降低，直至术后6个月保持稳定。前表面和总角膜曲率值保持不变，而后表面角膜曲率的变化在术后6个月内较为明显。术后前6个月观察到前表面、后表面和总散光量以及散光不对称性显著降低。直至术后12个月记录到前表面、后表面和总高阶像差逐渐降低。观察到CCT、MK、MA、AA和HOA的基线值与连续随访时间点这些参数的术后变化之间呈负相关。因此，发现基线CCT与术后角膜地形图参数变化之间存在负相关。
大多数角膜地形图参数在手术后6个月内趋于稳定，而高阶像差降低和BCVA改善在术后第一年逐渐发生。角膜地形图参数的术前值强烈决定了DMEK手术后检测到的变化，这可能表明早期治疗干预可带来更好的视觉效果。
