Postkeratoplasty Anterior and Posterior Corneal Surface Wavefront Analysis: Descemet's Stripping Automated Endothelial Keratoplasty versus Penetrating Keratoplasty

Purpose. To compare the higher-order aberrations (HOAs) due to the anterior and posterior corneal surfaces in patients that underwent either Descemet-stripping-automated-endothelial-keratoplasty (DSAEK) or penetrating keratoplasty (PK) for endothelial dysfunction and age-matched controls. Methods. This retrospective, observational, case series included 28 patients after PK, 30 patients after DSAEK, and 30 healthy controls. A Scheimpflug imaging system was used to assess the HOAs due to the anterior and posterior corneal surfaces at 4 mm and 6 mm optical zones. Total, 3rd and 4th order HOAs were considered. Intra- and intergroup differences were assessed using the Friedman and the Kruskal-Wallis tests, respectively; paired comparisons were performed using Duncan's multiple range test. Results. Total, 3rd and 4th order HOAs due to both corneal surfaces at 4 mm and 6 mm optical zones were significantly higher in the PK group, intermediate in the DSAEK group, and lower in controls (P < 0.05). The most important HOAs components in both PK and DSAEK groups were trefoil and coma from the anterior corneal surface (P < 0.05) and trefoil from the posterior corneal surface (P < 0.05). Conclusions. The optical quality of both corneal surfaces appeared significantly higher after DSAEK than after PK, which can increase the postoperative patient's quality of vision and satisfaction.