Two-Year Course of Corneal Densitometry After Descemet Membrane Endothelial Keratoplasty

PURPOSE: To investigate the 2-year course of corneal densitometry following Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy (FED). DESIGN: Retrospective, interventional case series. METHODS: Densitometry values (corneal light back scatter in grayscale units) measured by Scheimpflugbased imaging and clinical records of 160 eyes of 160 patients undergoing DMEK for FED were reviewed. Outcome measures included densitometry data in 4 corneal layers (anterior layer [AL], central layer [CL], posterior layer [PL], and total layer [TL]) and 2 annuli (central annular zone 0-2 mm and peripheral zone 210 mm), central corneal thickness (CCT), best spectacle-corrected visual acuity (BSCVA), and endothelial cell density (ECD) prior to DMEK and at 1, 3, 6, 12, and 24 months postoperatively. RESULTS: Corneal densitometry decreased in all 4 layers over 2 years after DMEK surgery. Regarding TL 0-2 mm, the reduction of corneal light backscatter was statistically significant for all follow-up time points compared with preoperative values (rho < .001) and compared in between follow-up periods (rho <= .010). Corneal light backscatter reduction was significantly higher in the center (0-2 mm) than in the periphery (2-10 mm) for all layers at 12 and 24 months (rho <= .002). ECD and CCT did not correlate with corneal densitometry, whereas BSCVA correlated moderately for TL 0-2 mm (rho = .026; r = 0.449) and TL 210 mm (P =.001; r = 0.585) at 12 months. CONCLUSIONS: Corneal light backscatter showed a significant reduction after DMEK surgery in Fuchs endothelial dystrophy over a period of 2 years, more pronounced in the corneal center, apparently in association with visual acuity improvement. (Am J Ophthalmol 2017;175:60-67. (C) 2016 Elsevier Inc. All rights reserved.