Relationship between Preoperative Corneal Thickness and Postoperative Visual Outcomes after Posterior Lamellar Corneal Transplant

Purpose: To evaluate the impact of preoperative corneal thickness on visual outcomes following Descemet’s stripping endothelial keratoplasty (DSAEK) or Descemet membrane endothelial keratoplasty (DMEK). Methods: This retrospective, observational study included patients aged > 18 years that underwent a posterior lamellar graft surgery (DSAEK or DMEK) for Fuchs dystrophy, pseudophakic endothelial decompensation or other endothelial dysfunction from October 2013 to November 2016. Exclusion criteria were the technical inability of preoperative CCT measurement, a history of penetrating keratoplasty in the study eye, the need for a penetrating keratoplasty following endothelial graft failure, preexisting stromal scarring before surgery (clinically assessed by the slit-lamp exam) and severe postoperative complications resulting in unquantifiable visual acuity. Visual acuity, central corneal thickness (CCT) and graft thickness were measured preoperatively and at postoperative day 7 and months 1, 3 and 6. Results: Forty-seven eyes (40 patients) were included in the final analysis. No significant association was observed between preoperative CCT and visual acuity at any postoperative time up to month 6 (r = 0.01; p = 0.94 at month 6). Preoperative CCT showed no association with visual acuity gain at any time up to month 6 (r = -0.02; p = 0.91 at month 6). Conclusion: Preoperative CCT does not predict the visual results achievable at 6 months after DSAEK or DMEK