Kolaib Mohamed Aly, Mahmoud Shahira, Ghaith Alaa Atef, Goweida Mohamed Bahgat
Alexandria Main University Hospital, Champollion Street, Al Mesallah Sharq, Al Attarin, Alexandria, Egypt.
Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Int Ophthalmol. 2025 Jul 21;45(1):301. doi: 10.1007/s10792-025-03669-1.
To investigate the effect of posterior corneal surface abnormalities following deep anterior lamellar keratoplasty (DALK) on visual outcomes and high order aberrations (HOA).
A retrospective cohort study was conducted on DALK cases. Patients were divided into two groups: Group A with posterior corneal surface abnormalities (interface haze, pre-Descemet's scarring, central Descemet's membrane (DM) perforation, and central DM folds) and Group B (control group) with regular posterior surface. Visual acuity, refractive outcomes, contrast sensitivity, and HOA were assessed in both groups.
This study included 84 eyes of 78 patients. Group A included 42 eyes of 38 patients and an equal number of control eyes were randomly included in group B. Group A exhibited significantly lower corrected distance visual acuity (CDVA) compared to Group B (Mean LogMAR 0.45 ± 0.25 in group A vs 0.31 ± 0.21 in group B, P = 0.012). Subgroup analysis revealed the lowest visual acuity in eyes with multiple posterior surface abnormalities, although the difference was not statistically significant. The mean topographic astigmatism was significantly higher in group A than in group B (4.47 ± 2.36 diopters vs 3.11 ± 2.16 diopters, respectively, P = 0.001). No significant differences were found between the 2 groups regarding total eye or corneal HOA. Contrast sensitivity was significantly lower in Group A at lower spatial frequencies (P = 0.013 and P = 0.004 at 3 and 6 cycles per degree, respectively), particularly in eyes with large DM perforations.
Posterior corneal surface abnormalities after DALK can negatively impact visual outcomes, especially contrast sensitivity.
探讨深板层角膜移植术（DALK）后角膜后表面异常对视觉效果和高阶像差（HOA）的影响。
对DALK病例进行回顾性队列研究。患者分为两组：A组为角膜后表面异常（界面混浊、后弹力层前瘢痕形成、中央后弹力层（DM）穿孔和中央DM褶皱），B组（对照组）为后表面正常。评估两组的视力、屈光结果、对比敏感度和HOA。
本研究纳入78例患者的84只眼。A组包括38例患者的42只眼，B组随机纳入数量相等的对照眼。与B组相比，A组的矫正远视力（CDVA）显著降低（A组平均LogMAR为0.45±0.25，B组为0.31±0.21，P = 0.012）。亚组分析显示，多个后表面异常的眼中视力最低，尽管差异无统计学意义。A组的平均地形图散光显著高于B组（分别为4.47±2.36屈光度和3.11±2.16屈光度，P = 0.001）。两组在全眼或角膜HOA方面未发现显著差异。A组在较低空间频率下的对比敏感度显著较低（在每度3和6周期间分别为P = 0.013和P = 0.004），特别是在DM穿孔较大的眼中。
DALK后角膜后表面异常可对视觉效果产生负面影响，尤其是对比敏感度。
