Changes in Corneal Curvatures and Anterior Segment Parameters after Descemet Stripping Automated Endothelial Keratoplasty

Purpose: To evaluate the influence of Descemet stripping automated endothelial keratoplsty (DSAEK) on corneal curvature and the anterior segment parameters obtained with the Pentacam rotating Scheimpflug camera. Methods: A total of 9 eyes of 9 consecutive patients (3 men, 6 women) were evaluated preoperatively, at 1 and 3 months postoperatively with the Pentacam. We compared preoperative and 1- and 3-month postoperative measurements of anterior and posterior corneal curvature, anterior and posterior corneal astigmatism, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) width, central corneal thickness (CCT), and the corneal volume (CV). Results: Preoperative CCT decreased from 687 ± 85 microns to 631 ± 68 microns at 3 months after surgery (p = 0.07). Anterior mean K reading of the cornea flattened from 43.3 ± 1.65 diopter before surgery to 42.7 ± 1.5 diopter at 3 months (p = 0.03). Anterior corneal astigmatism did not change significantly. Posterior mean K reading of the cornea steepened significantly from -5.6 ± 0.6 diopter preoperatively to -7.2 ± 0.4 diopter at 3 months (p = 0.007). Posterior corneal astigmatism increased accordingly from 0.52 ± 0.17 diopter before surgery to 0.95 ± 0.57 diopter at 3 months (p = 0.07). CV increased significantly from 65.8 ± 5.6 µl before surgery to 85.2 ± 4.2 µl at 3 months (p = 0.007). ACA, ACD, and ACV did not change significantly following DSAEK surgery. The average postoperative spherical equivalent changed from 0.5 ± 2.5 D before surgery to 1.41 ± 0.59 D three months after surgery (p = 0.05). Conclusions: DSAEK significantly increased posterior corneal k-reading, posterior corneal astigmatism, and corneal volume, resulting in a mild hyperopic shift. This observation should be taken into consideration when performing a triple procedure.