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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-07-2013 | Cornea

The impact of tear functions on visual outcome following keratoplasty in eyes with keratoconus

Authors: Shuya Hara, Takashi Kojima, Murat Dogru, Yuichi Uchino, Eiki Goto, Yukihiro Matsumoto, Tetsuya Kawakita, Kazuo Tsubota, Jun Shimazaki

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2013

Abstract

Background

To investigate the impact of preoperative and postoperative tear functions on visual outcome and the recovery of visual function following keratoplasty in eyes with keratoconus.

Methods

Twenty-five eyes of 25 consecutive patients (5 females, 20 males, mean age: 34.3 ± 15.8 years (range: 19–70 years) with keratoconus who underwent either penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) were included in this prospective study. One patient who had a rejection episode during the follow-up period was excluded. All subjects underwent best corrected visual acuity (BCVA), corneal topography (refractive cylinder, surface regularity index: SRI and surface asymmetry index: SAI), Schirmer I test, tear film break-up time (BUT), corneal sensitivity, and fluorescein staining score measurements before as well as 1, 3, 6 and 12 months after keratoplasty. The relation between the tear functions and the duration until the achievement of maximum BCVA was also evaluated. Linear regression analysis was performed to study the statistical significance of the correlations and the time wise change of each examined parameter.

Results

SRI, SAI, and BCVA significantly improved after keratoplasty. The postoperative corneal sensitivity was still significantly low even at 12 months postoperatively. Postoperative BCVA at 3, 6 months and maximum BCVA showed a significant linear negative correlation with the preoperative BUT (3 months; r = −0.461, p = 0.036, 6 months; r = −0.494, p = 0.023, maximum BCVA; r = −0.473, p = 0.030). The duration until the achievement of maximum BCVA showed a significant negative correlation with the preoperative Schirmer test (r = −0.429, p = 0.036). BCVA at 1 and 3 months postoperatively showed significant linear negative correlations with BUT value at the respective periods (1 month; r = −0.665, p = 0.0036, 3 months; r = −0.580, p = 0.0059).

Conclusion

Preoperative tear functions appeared to have an influence on postoperative BCVA and the duration of visual recovery in keratoconus patients undergoing keratoplasty. Postoperative tear film stability appears to play an important role for obtaining a better BCVA in the early postoperative period after keratoplasty.

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Title: The impact of tear functions on visual outcome following keratoplasty in eyes with keratoconus
Authors: Shuya Hara
Takashi Kojima
Murat Dogru
Yuichi Uchino
Eiki Goto
Yukihiro Matsumoto
Tetsuya Kawakita
Kazuo Tsubota
Jun Shimazaki
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2013
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-013-2307-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of tear functions on visual outcome following keratoplasty in eyes with keratoconus

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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