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Anterior-Segment Optical Coherence Tomography Investigation of Corneal Deturgescence and Epithelial Remodeling After DSAEK

Kanellopoulos, A. John MD; Asimellis, George PhD

doi: 10.1097/ICO.0000000000000053
Clinical Science

Purpose: The aim of this study was to evaluate via Fourier-domain anterior-segment optical coherence tomography 3-dimensional corneal, epithelial, and graft thickness changes after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: Sixteen eyes were investigated preoperatively and up to 6 months postoperatively for preoperative and postoperative central corneal thickness (CCT), minimum corneal thickness, central graft thickness (CGT), and for epithelial topographic thickness variability. An age-matched and gender-matched control group of 32 healthy eyes was used for comparison.

Results: In the DSAEK group, the preoperative CCT was 582.32 ± 45.24 (550–615) μm. One-month postoperatively, the CCT was 736.26 ± 34.52 (713–771) μm, and the CGT was 210.42 ± 34.52 (145–243) μm. Three months postoperatively, the CCT was 641.39 ± 38.75 (569–684) μm, and the CGT was 171.23 ± 27.54 (119–185) μm. The preoperative center epithelial thickness was 55.74 ± 9.29 (45–74) μm, the minimum was 32.53 ± 14.30 (13–53) μm, the maximum was 76.00 ± 11.32 (64–105) μm, and the topographic thickness variability was 10.84 ± 4.09 (5.90–18.80) μm. Three months postoperatively, the center epithelial thickness was 47.21 ± 5.45 (43–56) μm, the minimum was 35.11 ± 4.70 (30–41) μm, the maximum was 58.11 ± 6.51 (49–65) μm, and the topographic variability was 4.77 ± 1.48 (2.90–6.50) μm. The average differences were −8.53, +4.53, and −17.89 μm for the center, minimum, and maximum (P < 0.001, <0.001, and <0.001). Similar results were obtained 3 and 6 months postoperatively.

Conclusions: We present a near-term postoperative investigation of the corneal and epithelial thickness changes after DSAEK for bullous keratopathy, by in vivo, clinical anterior-segment optical coherence tomography. Epithelial thickness recovery and normalization and corneal deturgescence were noted as early as in the first postoperative month.

* Eye Institute, Athens, Greece; and

Department of Ophthalmology, New York University Medical School, New York, NY.

Reprints: A. John Kanellopoulos, Clinical Professor of Ophthalmology, NYU Medical School, New York, NY (e-mail:

The authors have no funding or conflicts of interest to disclose.

Design and conduct of the study (A.J.K.); collection (A.J.K.), management (A.J.K.), analysis (A.J.K., G.A.), interpretation of the data (A.J.K., G.A.); manuscript preparation (A.J.K., G.A.), manuscript review (A.J.K., G.A.), and manuscript approval (A.J.K.).

Consultant/advisory positions: A.J. Kanellopoulos: Alcon/WaveLight, Avedro, i-Optics, Oculus.

Received September 19, 2013

Accepted November 08, 2013

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.