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The importance of posterior astigmatism in DSAEK patients

Poster Details

First Author: A.Vicente PORTUGAL

Co Author(s):    L. Costa   R. Anjos   V. Lemos   R. Proenca   V. Maduro   J. Feijao     

Abstract Details


To present a retrospective study of the postoperative astigmatism in patients with DSAEK with a determination of anterior and posterior corneal astigmatism.


Centro Hospitalar Lisboa Central, Lisbon, Portugal


A retrospective study of corneal astigmatism in 30 patients with Fuchs Dystrophy submitted to DSAEK was performed. Postoperative total astigmatism, posterior and anterior corneal astigmatism were determined using anterior segment tomography (Scheimpflug Camera, Pentacam®), an optical biometer (Lenstar®) and a refractometer. Central corneal thickness was evaluated with anterior segment OCT (Visante®). Careful ophthalmological follow-up examination was performed and visual acuities and refraction were recorded.


Patients were in average 67,10±9,91 years old and the majority were women (66,3%). Mean central corneal thickness was 541,20±39,14μm. Anterior corneal astigmatism evaluation in these patients was associated with a considerable underestimation of corneal astigmatism (p<0.05). Comparisons between phakic and pseudophakic patients were also performed but differences in contribution from posterior corneal astigmatism to corneal astigmatism were not significant (p<0.05). In pseudophakic patients posterior corneal astigmatism was more important to total astigmatism than in phakic patients.


One of the major benefits of endothelial keratoplasty is a better visual and refractive outcome. Corneal astigmatism used to be one of the main complications associated with penetrant keratoplasty. The implementation of the DSAEK technique still induces a certain level of astigmatism and posterior corneal astigmatism is a relevant contributor together with anterior corneal astigmatism to the total astigmatism in these patients.

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