Effect of Descemet Membrane Endothelial Keratoplasty on Color Vision in Patients With Fuchs Dystrophy.

Abstract

To assess changes in color discernment after Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD). In this prospective, single-center study, the study group was composed of 26 patients with FECD, aged 46 to 85 years, who underwent DMEK as a single surgical procedure; 24 (92%) had pseudophakic and 2 (8%) had phakic eyes. The patients completed a computerized Farnsworth-Munsell 100-hue color vision test before and 1 month after DMEK. A control group of 14 subjects, aged 57 to 85 years, was tested 1 month after cataract surgery. The median number of errors made by patients who had undergone DMEK on the color vision test improved from 64 (range 24-124) before surgery to 48 (range 10-120) after surgery (P = 0.0053). The post-DMEK scores in the 24 patients with pseudophakic eyes (median = 48, range = 10-120) were comparable to those of an age-matched control group of patients with cataract without corneal abnormalities (median = 53, range = 4-104, P = 0.88). The improvement in color vision was not correlated with the amount of improvement in best corrected visual acuity (r = -0.02, P = 0.91) or with the reduction in central pachymetry (r = -0.08, P = 0.71) after DMEK. Consistent with spontaneous comments from some patients with FECD that colors appear more vivid after DMEK, a comparison of pre- and postoperative color vision scores showed that color discernment usually improved after DMEK (81%). The lack of correlation between color vision improvement and pachymetry reduction leads us to hypothesize that color vision improvement may relate to removal of the guttae associated with FECD.