Long-term anterior and posterior topographic analysis of the cornea after deep lamellar endothelial keratoplasty

PURPOSE: To analyze the 2-year topographic response of the cornea to deep lamellar endothelial keratoplasty (DLEK). METHODS: The Orbscan topographies of 24 eyes that underwent DLEK for corneal decompensation were retrospectively analyzed. Twelve eyes received a large-incision DLEK technique and 12 eyes received a small-incision DLEK. All the preoperative and postoperative corneal raw data were imported into a custom software program, which computed the average composite corneal maps and difference maps for both study groups to evaluate the corneal response to the surgery. The software delineated 2 concentric zones of the cornea to characterize the regional response after the surgery: the central and peripheral regions. RESULTS: At 2 years after surgery, no significant changes ( 0.05) in the central topography configuration were measured in comparison with the preoperative state after DLEK procedures. On the other hand, a significant increase (P <0.01) in the mean tangential curvature and astigmatic power of the anterior corneal periphery was measured after surgery, with higher changes after large-incision DLEK. No significant differences in the average curvature profile of the posterior corneal interface were measured after DLEK procedures ( 0.05) in comparison with the preoperative state. CONCLUSIONS: DLEK provides stable central corneal topography, with minimal changes in curvature and astigmatic power in the years after surgery. Moreover, the donor posterior cornea shows to maintain its vitality and integrity in the long-term postoperative period, with curvature values similar to the original posterior corneal interface.