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

Objective: To investigate the 2-year course of corneal densitometry following Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy (FED).

Methods: Retrospective, interventional case series. Methods: Densitometry values (corneal light backscatter in grayscale units) measured by Scheimpflug-based 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 2-10 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 (P < .001) and compared in between follow-up periods (P ≤ .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 (P ≤ .002). ECD and CCT did not correlate with corneal densitometry, whereas BSCVA correlated moderately for TL 0-2 mm (P = .026; r = 0.449) and TL 2-10 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.