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Theofilos Tourtas, Victor A Augustin, Julia Weller, Friedrich E Kruse; Influence of Fuchs endothelial corneal dystrophy on contrast sensitivity in cataract patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1311.
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© ARVO (1962-2015); The Authors (2016-present)
Patients with early stages of Fuchs endothelial corneal dystrophy (FECD) suffer rather from impaired contrast sensitivity (CS) than reduced visual acuity. The aim of this study was to evaluate the CS in patients with early FECD and cataract when compared to cataract patients without guttae.
In this retrospective, single-center, consecutive case series 25 eyes of 25 patients with FECD and cataract were analyzed (study group). 22 eyes of 22 cataract patients without guttae served as a control group. All patients underwent either uneventful Descemet membrane endothelial keratoplasty (DMEK) combined with cataract surgery (n=25) or uneventful cataract surgery (n=22). Inclusion criteria were equal preoperative best-corrected visual acuity (BCVA) ≥ 20/40 (Snellen), same lens opacity (Lenticular Opacity Classification System II) and the absence of other ocular comorbidities. Main outcome measures included BCVA (logMAR), MARS Letter Contrast Sensitivity Test (Log CS), and central corneal thickness (CCT). All eyes fulfilled a three months follow up. The study was approved by the Institutional Review Board at Friedrich Alexander University of Erlangen-Nuremberg as a retrospective data review.
Mean preoperative BCVA was 0.26 ± 0.06 in the study group and 0.24 ± 0.07 in the control group (p = 0.284). Mean preoperative CS was significantly worse in the study group (0.99 ± 0.11) than in the control group (1.38 ± 0.16; p < 0.001). Mean preoperative CCT was 569 ± 26μm in the study group and 552 ± 33μm in the control group (p = 0.064). CS and BCVA increased significantly in both groups after surgery. No significant difference was shown in MARS letter CS between the study group (1.51 ± 0.16) and the control group (1.57 ± 0.13; p = 0.225) three months after surgery. However, cataract patients in the control group showed better BCVA after surgery (0.02 ± 0.06) compared to FECD patients (0.10 ± 0.08; p = 0.004). There was no significant difference in CCT after surgery (study group: 537 ± 32; control group: 541 ± 42; p = 0.719).
The contrast sensitivity in patients suffering from FECD and cataract is significantly reduced when compared to cataract patients with equal visual acuity and lens opacity. Therefore the decision to perform a DMEK surgery should take the contrast sensitivity into account. Further studies will help to elucidate the relevance of contrast sensitivity in FECD patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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