Abstract
Purpose :
To assess differences in color-, contrast sensitivity and subjective perception after Descemet’s Membrane Endothelial Keratoplasty (DMEK) in patients with Fuchs’ endothelial corneal dystrophy (FECD).
Methods :
Included in this study were pseudophakic, unilateral DMEK patients with bilateral FECD (n=23). The follow-up period ranged from 6 to 17 months, mean 10 months. Eyes without history of ocular pathology or ocular surgery served as a control (n=10). Pelli-Robson contrast sensitivity test and Panel D15 color vision test were used. Modified Visual Functioning Questionnaire 25, best-corrected visual acuity (BCVA) and endothelial cell density (ECD) were assessed. We visualized the subjective impression of patients with bilateral FECD after unilateral DMEK in a subgroup (n=5) using Photoshop CS6 parameters for contrast, brightness, saturation and sharpness. Statistical analyses were performed using Microsoft Excel and IBM SPSS.
Results :
All results are based on 6 months:
Contrast sensitivity for DMEK-operated eyes was 1.65 ± 0.1557, for FECD-affected eyes 1.35 ± 0.2577 and for control eyes 1.92 ± 0.0949. DMEK-operated eyes showed a significant increase of contrast sensitivity (p=0.0053).
There was no difference in color vision between DMEK-operated and FECD-affected eyes (p=0.3200).
Scores in the general and the driving questionnaire were significantly higher in DMEK-operated than in FECD-affected eyes (p=0.0001 and p=0.0001, respectively). DMEK-operated and control eyes showed no significant differences in both questionnaires (p=0.1153 and p=0.5171, respectively).
The BCVA was significantly better in DMEK-operated eyes (p=0.0001). The average values in logMAR were 0.1 ± 0.1049 in DMEK-operated eyes, 0.5913 ± 0.4188 in FECD-affected eyes and 0.01 ± 0.0316 in control eyes.
Routine examinations revealed an insignificant decrease of the ECD of the DMEK-operated eyes (p=0.0833). The ECD of FECD-affected eyes was not measurable.
Conclusions :
This study showed significant improvement in subjective patient satisfaction and contrast sensitivity. Spontaneous subjective color vision improvement might be explained by significantly improved contrast sensitivity. Contrast sensitivity might be considered as an important parameter in preoperative decision making and evaluation of surgical results.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.