Role Of Corneal Tomography In Determining The Outcomes Of Descemet Membrane Endothelial Keratoplasty In Fuchs Endothelial Corneal Dystrophy

To study the Scheimpflug tomography changes before and after surgery in patients undergoing Descemet Membrane Endothelial Keratoplasty for Fuchs endothelial corneal dystrophy (FECD).

Retrospective observational Institutional study conducted at Dr. Rajendra Prasad Centre for ophthalmic sciences, New Delhi, India

The study included ten eyes of 10 patients with grade 4 FECD (Krachmer classification system) who underwent Descemet Membrane Endothelial keratoplasty (DMEK). Scheimpflug imaging was done in all eyes pre-DMEK and the imaging was repeated post-DMEK to look for changes in the tomographic features. Both images were assessed by two masked observers for topographical changes.

Pre-DMEK, all eyes showed a loss of regular isopachs, displacement of the thinnest corneal point and posterior surface depression on tomography. Post DMEK, there was regularization of isopachs, shifting back of the thinnest corneal point and decrease or disappearance of posterior corneal depression in all the eyes. One eye which developed graft failure secondary to rejection developed a reversal of these changes signifying the potential benefit of the role of Scheimpflug in detecting early graft failure.

Scheimpflug tomography changes occur in eyes with FECD which reverse after successful DMEK. The Scheimpflug tomographic imaging could be used to monitor the disease and could be potentially useful in detecting failing grafts.