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Michael Rudolph, Kathrin Laaser, Bjoern O. Bachmann, Claus Cursiefen, Stephan Riss, Friedrich E. Kruse; Contrast Sensitivity After Descemet Membrane Endothelial Keratoplasty (DMEK). Invest. Ophthalmol. Vis. Sci. 2012;53(14):63.
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© ARVO (1962-2015); The Authors (2016-present)
Descemet membrane endothelial keratoplasty (DMEK), a lamellar technique for sole replacement of the endothelium-Descemet’s membrane layer (EDM), is currently replacing penetrating keratoplasty (PK) for selective treatment of diseases of corneal endothelial cells. In most studies visual acuity serves as the major outcome measure. However since glare is the leading complaint of patients with Fuchs’ endothelial dystrophy we retrospectively investigated contrast sensitivity (CS) in patients after DMEK in comparison to controls.
13 patients who underwent DMEK with a standardized approach were analyzed by the Optec 6500P contrast sensitivity tester. Test conditions included photopic illumination (85cd/m²), photopic illumination with 10 Lux glare, mesopic illumination (3cd/m²) and mesopic illumination with 1 Lux glare. Data was compared with 31 patients who had undergone cataract extraction via phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation. Patients were examined 6.29 ± 0.94 months after DMEK and 11.77 ± 2.19 months after PCIOL implantation.
Mean age was 52.7 ± 17.9 in DMEK group and 72.0 ± 9.3 in PCIOL group (p=0.007). Contrast sensitivity values are given in table 1. Mean values for 1.5 cycles per degree (cpd) showed significant differences between both groups under photopic illumination (p=0.01) and photopic illumination with glare (p=0.044). There were no significant differences for 3, 6, 12 and 18 cpd. When comparing mean contrast sensitivity values between DMEK and control group there were no statistically significant differences under mesopic conditions.
In an earlier report we have shown that DMEK (in contrast to DSAEK) renders nearly normal postoperative higher order aberrations 6 months after surgery. Here we demonstrate that DMEK renders normal contrast sensitivity values at the same time. These results seem to explain the favorable visual function after DMEK.
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