Corneal Deturgescence after Descemet Stripping Automated Endothelial Keratoplasty Evaluated by Visante Anterior Segment Optical Coherence Tomography

PURPOSE: To evaluate postoperative corneal deturgescence after Descemet stripping endothelial keratoplasty (DSAEK) using the Visante anterior segment optical coherence tomography (OCT) system (Carl Zeiss Meditec Inc, Dublin, California, USA). DESIGN: Retrospective case series. METHODS: We included 21 eyes (9 males and 12 females; mean age +/- standard deviation, 76.3 +/- 12 years). The Visante OCT system was used to determine the central and peripheral endothelial keratoplasty graft thickness and total central and peripheral corneal thickness. RESULTS: Central graft thickness decreased from the first day (243.3 +/- 92 mu m) to the last visit (147.8 +/- 44 mu m; P = .0001). The rate of central graft thinning slowed during the following intervals: during the first week (47 mu m), at 1 week to 1 month (40 mu m), and at 1 to 6 months (25 mu m), with a mild increase at 6 to 9 months (5 mu m). Peripheral graft thickness continued to decrease from postoperative day 1 (318.5 +/- 99 mu m) to the last visit (196.7 +/- 50 mu m; P = .0001). There was a decrease in total central corneal thickness from day 1 (903.8 +/- 179 mu m) to the last visit (671 +/- 93 mu m; P = .0001). All patients were imaged with the Visante OCT at the first 4 defined postoperative intervals; however, only 9 eyes were imaged at the last interval of 6 to 9 months. CONCLUSIONS: After DSAEK, there is a greater thinning of the central graft compared with the peripheral graft. The central cornea thickness decreases and peripheral corneal thickness increases. Central corneal graft deturgescence stabilizes by 6 months after surgery. (Am J Ophthalmol 2009;148:32-37. (C) 2009 by Elsevier Inc. All rights reserved.)