DSAEK graft effect on refractive power holds implications for cataract surgery patients

A study from Duke University Eye Center showing that Descemet's stripping automated endothelialkeratoplasty (DSAEK) grafts add refractive power to the posterior surface of the cornea hasimplications for graft patients undergoing cataract surgery.

"Further studies are warranted to understand the mechanism of the refractive change associatedwith the DSAEK graft," said Bokkwan Jun, MD, research associate, Duke University, Durham, NC."However, we recommend considering adjusting the IOL power in patients undergoing a DSAEKtriple procedure (DSAEK, phacoemulsification, and IOL implantation) and in DSAEK patientsundergoing cataract surgery."

Dr. Jun and colleagues undertook a retrospective review of all cases of DSAEK surgery performedby three surgeons at the Duke University Eye Center between August 2005 and December 2006, inorder to investigate any postoperative refractive change and correlations with graft thicknessand diameter. Data were analyzed for a total of 45 cases of 44 patients that had at least 3months follow-up after DSAEK and refractive data preoperatively and at last follow-up.

The overall refractive change in the 45 eyes was +0.88 D. After subgroup classification, themean refractive change was +1.15 D in 17 eyes that underwent DSAEK triple surgery and +0.71 Din 28 pseudophakic DSAEK eyes. The difference between the two groups was not statisticallysignificant.

A negative correlation was found between the amount of refractive change and graft centralthickness, although it was not statistically significant. There was a positive correlationbetween the refractive change and graft diameter that approached statistical significance(p = 0.05).