Abstract
Purpose: To study the role of higher-order aberrations (HOAs) in impairment of best-corrected visual acuity (VA) and contrast sensitivity (CS) following PK, DALK and DSAEK surgeries.
Methods: Eyes were evaluated 3 months (PK, n=2; DALK, n=1; DSAEK, n=2) and greater than 1 year (PK, n=4; DALK, n=5; DSAEK, n=3) post-keratoplasty. An adaptive optics (AO) system was used to non-invasively correct the HOAs; VA and CS was then measured without and with AO.
Results: Without AO, PK eyes had 1.05 ± 0.79 and 1.07 ± 0.43, DALK had 1.02 and 0.69 ± 0.24, and DSAEK eyes had 0.67 ± 0.36 and 0.65 ± 0.43 μm of root mean square HOA at 3 months and 1 year post-op, respectively. At 3 months, without and with AO correction, PK eyes achieved logMAR VAs of 0.32 ± 0.13 and 0.08 ± 0.10, DALK VAs of 0.09 and 0, and DSAEK VAs of 0.36 ± 0.12 and 0.25 ± 0.06. At one year these acuities improved to 0.02 ± 0.12 and -0.12 ± 0.15 for PK, 0.11 ± 0.18 and -0.05 ± 0.18 for DALK, and 0.24 ± 0.15 and 0.01 ± 0.10 for DSAEK. All post-op groups benefited equally with regards to CS when aberrations were corrected with AO.
Conclusions: Despite having less HOA than PK eyes and the same amount as DALK eyes, DSAEK subjects tended toward poorer performance on VA testing, and did not achieve similar acuities as PK and DALK subjects when aberrations were corrected with AO. This suggests that other factors, such as scatter, may be playing a proportionately larger role in limiting visual performance in DSAEK.