A 63-year-old man with Fuchs' dystrophy and cataract underwent successful phacoemulsification, insertion of a posterior chamber intraocular lens, and Descemet's stripping endothelial keratoplasty (DSEK) of the right eye. At 1-month follow-up, measurement of central corneal thickness (CCT) obtained by ultrasound pachymetry was 549 μm. The ultrasound pachymetry measurement was thought to be an artifact, so anterior segment optical coherence tomography analysis of the right eye was performed. Both host and graft tissue were imaged in cross-section; optical coherence tomography measurement of CCT was 769 μm. Reliable measurements of CCT are clinically important following DSEK. This case demonstrates that anterior segment optical coherence tomography imaging and analysis software may provide a more appropriate measurement of CCT in patients who have undergone DSEK.
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