The effect of corneal light scatter on vision after descemet stripping with endothelial keratoplasty

Objective: To establish an association between corneal light scatter and vision after Descemet stripping with endothelial keratoplasty (DSEK). Methods: Twenty eyes of patients with Fuchs endothelial dystrophy were examined before and at 1,3, and 6 months after DSEK in a prospective study. Main outcome measures were high-contrast best-corrected visual acuity, intraocular forward light scatter, and corneal backscatter. Results: One eye was excluded because of endothelial graft failure within 1 month. Best-corrected visual acuity improved at 3 months after DSEK (mean [standard deviation], 0.31 [0.20] logarithm of the minimum angle of resolution [logMAR]; Snellen equivalent, 20/41) relative to before DSEK (0.46 [0.26] logMAR; Snellen equiva-lent, 20/58; P = .03). Posterior corneal backscatter decreased 1 month after DSEK (P< .001), but backscatter from the anterior, middle, and posterior cornea did not return to normal by 6 months (P≤ .02). At 6 months, best-corrected visual acuity correlated with recipient age (r = 0.84, P < .001) and with intraocular forward light scatter (r =0.67, P< .001); forward light scatter also correlated with recipient age (r=0.67, P< .001). Conclusions: Six months after DSEK, corneal light scatter remained greater in eyes with Fuchs endothelial dystrophy than in normal eyes and correlated with recipient age and visual acuity. Recipient age might be the best preoperative predictor of vision after DSEK.