Anatomical Changes in the Anterior Chamber Volume After Descemet Membrane Endothelial Keratoplasty

Purpose: To evaluate changes in the anterior chamber of eyes that have undergone Descemet membrane endothelial keratoplasty (DMEK) and to identify factors that affect these changes. Methods: This retrospective study included 25 pseudophakic eyes of 25 patients who underwent DMEK. We determined the preoperative and postoperative values of the best spectacle-corrected visual acuity, spherical equivalent (SE), anterior chamber volume (ACV), anterior chamber depth (ACD), central corneal thickness (CCT), and scleral spur angle (SSA) evaluated using anterior segment optical coherence tomography and iris damage score and iris posterior synechiae score. We defined Delta as the average change rate from the preoperative to postoperative value for each factor at 1 month (SE at 6-12 months) postoperatively. We also analyzed correlations between Delta ACV, Delta SE, and other preexisting factors. Results: Compared with the preoperative ACV value (128 +/- 28 mm(3)), the postoperative value significantly increased to 155 +/- 21 mm(3) (P < 0.001); Delta SE was +1.01 +/- 1.09 diopters. Delta ACV was negatively correlated with preoperative ACD (R = 0.643, P < 0.001) and SSA (R = 0.555, P = 0.001) and positively correlated with Delta ACD (R = 0.799, P < 0.001) and Delta SSA (R = 0.608, P < 0.001). Delta CCT, iris damage score, and iris posterior synechiae score were not significantly correlated with Delta ACV. Delta SE was positively correlated with Delta ACV, Delta ACD, and Delta SSA (R = 0.680, 0.455, and 0.478; P < 0.001, <0.05, and <0.05, respectively). Conclusions: An increase in the ACV and hyperopic change was noted after successful DMEK, especially in eyes with narrow-angled shallow anterior chambers.