Abstract
This study focused on defining the characteristic features of keratometry and pachymetry elevation maps based on swept source optical coherence tomography (SS OCT) in Fuchs endothelial corneal dystrophy (FECD) eyes with a coexisting cataract. 70 eyes of 35 patients diagnosed with FECD and a coexisting cataract and 70 control eyes were included in this prospective, controlled, observational, cross-sectional study. Features characteristic of intermediately affected eyes included an increased corneal thinnest thickness (CTT) (p = 0.01), 3 and 6 mm asymmetry (p < 0.0001), higher order Fourier indices (p < 0.05 and p ≤ 0.0001, respectively), chord µ, and a posterior Ectasia Screening Index (pESI) (p < 0.01). The lack of agreement between the anterior and posterior elevation map and a significant area of negative values in the posterior map were detected. In advanced FECD eyes, our study additionally revealed decreased posterior keratometry steep (Ks), keratometry flat (Kf), keratometry average (AvgK), eccentricity (Ecc), an increased corneal apex thickness (CAT), and decreased 3 and 6 mm posterior spherical indices (p < 0.0001 for all of the above). Characteristic features of subclinical FECD, independent of the corneal thickness, can be detected by SS OCT and should be considered during the preoperative assessment of patients with a coexisting cataract.
Highlights
Cataracts, according to World Health Organization (WHO) data, remain one of the main leading causes of vision impairment globally [1]
We revealed a significant difference in the posterior corneal shape parameters of pKs, pKf, pAvgK, and the posterior eccentricity of the corneal curve within 9.0 mm
We reveled a significant difference in chord μ values between Fuchs endothelial corneal dystrophy (FECD) and controls (p < 0.01)
Summary
Cataracts, according to World Health Organization (WHO) data, remain one of the main leading causes of vision impairment globally [1]. Optimal precision in the refractive outcome in cataract surgery depends on a precise preoperative assessment and attention to pre-existing ocular comorbidities [2,3,4]. The proportion of coexisting ocular comorbidities according to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) is high and ranges from 27 to 30% and should be taken into consideration while qualifying patients for cataract surgery [2]. FECD typically manifests in the fifth or sixth decades of life, with a greater incidence in women (female:male ratio of 3–4:1) [6]. In Caucasians, cornea guttata was diagnosed in 11% of females and 7% of males of the population over the age of 55 [8]
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