Clinical study to estimate correlation between graft thickness as measured by anterior segment Optical Coherence Tomography and visual recovery after manual Descemet stripping endothelial keratoplasty

Purpose: To estimate the correlation between graft thickness as measured by anterior segment Optical Coherence Tomography and visual recovery after manual Descemet stripping endothelial keratoplasty. Design: Prospective observational study. Materials and methods: This prospective observational study included 25 patients with pseudophakic bullous keratopathy, who underwent DSEK. Visual acuity in LogMAR units and estimation of graft thickness measured by Anterior Segment Optical Coherence Tomography (AS-OCT) was carried out on postoperative day 1, 3rd month and 6th month. Correlation analysis was performed between graft thickness and postoperative visual acuity on postoperative day 1, 3rd month and 6th month. Results: The mean LogMAR visual acuity improved in all patients post DSEK - 1.47 (±0.48) to 0.75 (±0.38) LogMAR units. The average postoperative day 1 central corneal thickness was 724.96 µm (±77.59 µm), which decreased to mean central corneal thickness of 655.56 (±61.08 µm) on 3rd month and 633.48 (58.72) by the 6th month. Mean donor graft thickness on postoperative day 1, 3rd month and 6th month in this study was found to be 169.3 µm (±36.6 µm), 135.9 µm (±29.8 µm) and 127.5 µm (±31 µm) corresponding to a BCVA of 1.94, 0.86 and 0.75 LogMAR units respectively. On correlation analysis, thinner grafts were found to be associated with better postoperative BCVA especially on the 3rd and 6th month follow-up period. Conclusion: This study found that a higher proportion of thinner grafts achieved better postoperative visual rehabilitation and earlier stabilization of visual acuity.