Fellow eye comparison of corneal thickness and curvature in descemet membrane endothelial keratoplasty and descemet stripping automated endothelial keratoplasty

Purpose: To compare posterior corneal curvature in the fellow eye of the same patients after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: This retrospective, case series comparative study included consecutive patients who underwent DSAEK in one eye and DMEK in the fellow eye. Each eye underwent corneal evaluation with Pentacam HR (Oculus, Wetzlar, Germany). Postoperative corneal curvature, corneal thickness, and visual acuity were assessed. Results: Twenty eyes of 10 patients (5 women and 5 men) aged 72.5 ± 13.5 (range, 42-87) years were included. No significant differences were observed between front flat K's (43.01 ± 1.6 vs. 43.5 ± 0.9, P = 0.27) and front steep K's (44.17 ± 1.5 vs. 44.52 ± 0.7, P = 0.39) in DMEK vs. DSAEK eyes, accordingly. Posterior curvature was statistically significantly flatter in DMEK compared with DSAEK eyes; back flat K's (-6.30 ± 0.2 vs. -6.84 ± 0.6, P = 0.012), back steep K's (-6.64 ± 0.1 vs. -7.2 ± 0.3, P = 0.03), and back Km (-6.45 ± 0.1 vs. -6.99 ± 0.4, P = 0.005), accordingly. Corneas in DMEK eyes were significantly thinner than in DSAEK eyes (541.0 ± 61 vs. 627.9 ± 70 μm, P = 0.007). Conclusions: Eyes that underwent DSAEK surgery have thicker corneas with steeper posterior corneal curvature than fellow eyes that underwent DMEK. This difference may explain the hyperopic shift commonly observed after DSAEK and should be considered when choosing an intraocular lens for cataract surgery.