Assessing the Relationship between Graft-Host Junction Profile and Corneal Astigmatism and Higher-Order Aberrations in Postpenetrating Keratoplasty Eyes.

Purpose: To assess the relationship between graft-host junction (GHJ) profile and corneal astigmatism and higher-order aberrations (HOAs) in postpenetrating keratoplasty (post-PKP) eyes.

Methods: A retrospective observational cross-sectional study was carried out at the Corneal Department of the Farabi Eye Hospital from April 2019 to March 2020. The objective of the study was to review the clinical records of 32 eyes belonging to 25 patients who had undergone PKP. The classification of the eyes was based on the most frequent alignment pattern observed in the eight GHJ sections using anterior segment optical coherence tomography (AS-OCT). The three classifications included the well-apposed junction, mal-apposed junction, and equally apposed junction.

Results: A total of 256 GHJ sections were analyzed in 32 AS-OCT images, comprising 24 keratoconus and 8 nonkeratoconus eyes. Among them, 10 eyes (31.25%) exhibited well-apposed junctions, 15 eyes (46.8%) had mal-apposed junctions, and 7 eyes (21.8%) displayed equally apposed junctions. The most prevalent type of mal-apposition observed was protrusion, accounting for 67 sections (25.3%). The mal-apposed group displayed a significantly higher mean spherical equivalent (SE) (P = 0.01) and postoperative astigmatism (P < 0.001), whereas there was no significant difference in total HOAs between the mal-apposed group and the other groups (P = 0.58).

Conclusions: Significant associations were observed between the alignment pattern of GHJ after PKP and both SE and keratometric astigmatism. Conversely, no significant association was found between the alignment pattern of GHJ and HOAs.