Refractive changes after Descemet membrane endothelial keratoplasty

Penetrating keratoplasty has different refractive disadvantages in contrast to posterior lamellar keratoplasty. For example, a decentered corneal trephination and a tilted trephination or unevenly tightened corneal sutures can cause an uncontrolled high astigmatism as well as a refractive change. Also the postoperative refraction may change over time as a result of wound healing, suture loosening or suture removal. The aim of this retrospective study was to investigate a possible refractive change after Descemet membrane endothelial keratoplasty (DMEK). A total of 139 pseudophakic eyes from 125 patients with endothelial decompensation had undergone DMEK surgery at the Tubingen Eye Clinic. After a mean postoperative time of 13.15 +/- 2.98 months after DMEK discreet mean changes in the spherical equivalent of + 0.37 +/- 0.87 diopters and the cylinder to -aEuro parts per thousand 0.45 +/- 0.57 diopters were observed. The mean central corneal thickness decreased from 670 +/- 70 A mu m to 544 A +/- 55 A mu m. In conclusion after DMEK a discreet induced hyperopic refractive shift due to the reversal of stromal swelling was observed.