Abstract
Purpose:
To determine changes in visual acuity, contrast sensitivity and color vision, as well as their effect in the subjective visual function after Descemet membrane endothelial keratoplasty (DMEK) in patients suffering from bilateral Fuchs’ endothelial dystrophy (FED).
Methods:
Patients with a history of bilateral FED and unilateral DMEK were identified and a total of 29 patients were included in the study, as well as 11 control subjects. The study participants were divided in three groups (phakic (n=12), pseudophakic (n=17), control (n=11)). Patients with unilateral cataract, unilateral IOL, previous anterior segment surgery or any other concurrent ocular condition that may limit best corrected visual acuity (BCVA) under 20/40 (0.5) were excluded. Pelli Robson contrast sensitivity test and Fansworth Munsell 100 Hue color vision test were used to assess contrast sensitivity and color vision. A specific questionnaire consisting of 11 questions was developed to measure the subjective visual quality. Individual variability was taken into account by measuring all visual parameters for the untreated (FED) and the treated eye (DMEK) of each subject. All parameters were compared between the phakic, pseudophakic and the control group.
Results:
Comparing the eyes of each patient, statistically significant differences in BCVA and contrast sensitivity were found for the phakic and pseudophakic group between FED and DMEK eyes. Contrast sensitivity of DMEK eyes in the phakic group does not significantly differ from the control group, while it does differ significantly between the DMEK eyes of the pseudophakic group and the control group. No statistically significant difference was observed in the mean color vision of the FED and the DMEK eyes for the phakic and the pseudophakic group. Subjective vision quality was rated significantly higher for the DMEK eye than for the FED eye in both the phakic and the pseudophakic group.
Conclusions:
For phakic and pseudophakic patients with bilateral FED, contrast sensitivity and BCVA were significantly improved in DMEK eyes compared to the untreated fellow eye. Improvement of those parameters after surgery influenced the subjective perception of patients’ visual quality.
Keywords: 741 transplantation •
481 cornea: endothelium •
478 contrast sensitivity