INVESTIGATION OF SCHEIMPFLUG CORNEAL DENSITOMETRY PREDICTIVE VALUE FOR VISUAL OUTCOMES THROUGHOUT 5 YEARS AFTER DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY (DMEK)

Investigation of Scheimpflug corneal densitometry predictive value for visual outcomes throughout 5 years after Descemet membrane endothelial keratoplasty (DMEK)

Department of Ophthalmology, Philipps University of Marburg, Germany

First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece

From a larger pool of 342 consecutive DMEK procedures, 58 uneventful cases (51 patients) with a minimum follow-up of 5 years were included in this study. Scheimpflug tomography (Pentacam HR^®, Oculus) was used to evaluate preoperative CD of various corneal layers (anterior, central, posterior and total layer) and zones (0-2 mm, 2-6 mm and 6-10 mm). Endothelial Cell Density, Best Corrected Visual Acuity (BCVA) and, Central Corneal Thickness were also evaluated. Assessment of diagnostic power was performed by the receiver operating characteristic analysis (ROC), calculating the area under the curve (AUC). The cut-off point was BCVA 0.3 logMAR at each time point. All tests were performed at 95% level of significance (p<0.05).

Postoperative BCVA was significantly better after DMEK for every examination time point (p<0.001). ECD and CCT significantly decreased from preoperatively to 5 years time point (p<0.001). ROC analyses revealed mainly good (AUC 0,8-0,9) and, in some cases, fair (AUC 0,7-0,8) predictive power results at each time point. The best predictive power was found for the anterior layer and central layer of the 2-6 mm zone (compared to the 0-2 mm and 6-10 mm zones). The highest predictive power values were observed at 6 months postoperatively.

Preoperative CD seems to present good prognostic value of visual outcome after DMEK throughout 5 years, being a useful index of postoperative visual outcome.