Retinal point-spread function after corneal transplantation for Fuchs' dystrophy

PURPOSE. To determine the effect of corneal transplantation for Fuchs' dystrophy and of recipient age on the large- and smallangle domains of the retinal point-spread function. METHODS. Retinal stray light (large-angle domain) and the fullwidth- at-half-maximum intensity of the point-spread function (50% width, small-angle domain) were measured in 40 pseudophakic eyes after keratoplasty (Descemet stripping with endothelial keratoplasty [DSEK], 30 eyes; penetrating keratoplasty [PK], 10 eyes) for Fuchs' dystrophy and in 30 otherwise normal pseudophakic eyes. Correlations were assessed between the optical variables, high-contrast visual acuity (HCVA), and recipient age, and variables were compared between groups by using generalized estimating equation models. RESULTS. The 50% width was higher in pseudophakic eyes after DSEK or PK compared with otherwise normal pseudophakic eyes (P<= 0.001) but did not differ between DSEK and PK (P = 0.36). After DSEK, HCVA correlated with the 50% width (r = 0.48, P = 0.001, n = 25) and stray light (r = 0.44, P = 0.01, n = 30), whereas after PK, HCVA correlated with the 50% width (r = 0.77, P = 0.003, n = 10) but not with stray light (r = 0.01, P = 0.98, n = 8). Stray light correlated with recipient age after DSEK (r = 0.67, P < 0.001, n = 30), but not after PK (r = 0.35, P = 0.39, n = 8,), and not with age of otherwise normal pseudophakic eyes (r = 0.32, P = 0.18, n = 29). CONCLUSIONS. The degradation of the small-angle domain of the point-spread function after DSEK suggests that aberrations contribute to decreased visual acuity after DSEK. The poorer optical properties of the eye with older recipient age after DSEK can be attributed to the retained host cornea.