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Claus Cursiefen, Silvia Schrittenlocher, Bjoern Bachmann, Kai Velten; Preoperative visual acuity predicts outcomes after DMEK. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4781.
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© ARVO (1962-2015); The Authors (2016-present)
To identify if and how preoperative visual acuity predicts visual acuity outcomes after DMEK.
1000 consecutive patients having undergone pseudophacic DMEK or Triple-DMEK from the prospective Cologne DMEK database were analyzed for correlations between pre- and postoperative visual acuity values at 1, 3, 6, and 12 months after transplantation. Analysis was done using Latex textprocessing combined with R statistical analysis (www.r-project.org).
There is a significant correlation between pre- and postoperative visual acuity (VA) after (Triple)-DMEK. Preoperative VA below 20/80 leads to delayed and reduced final visual acuity results after 12 months, whereas VA between 20/80 and 20/40 just take longer to reach good final VA values, which are reached faster for preoperative VA values above 20/40. There is only a mild predictive value of preoperative corneal thickness on postoperative VA. There is no significant differences for preoperative VA values above 20/40. The chance to reached postoperative VA above 20/25 is 40% for preoperative VA of 20/200, 50% for preoperative VA of 20/60 and > 60% for preoperative VA of 20/40.
DMEK results in very good final postoperative visual acuity results even in eyes with bad preoperative vision due to corneal pathology. However, below preoperative acuity values of 20/80 recovery is significantly poorer and delayed. This suggests to operate early enough to achieve good final visual acuity results. Preoperative visual acuity seems to be a good predictor for final outcome.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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