Progressive changes in visual function after Descemet membrane endotelial keratoplasty

Abstract

PurposeObjectives: To evaluate progressive changes in visual function parameters in patients with Fuchs endotelial dystrophy (FED) who underwent Descemet membrane endotelial keratoplasty (DMEK) and to compare visual results after DMEK with visual function parameters in healthy subjects without corneal pathology.MethodsMethods: Fourteen patients (14 eyes) with FED who underwent DMEK surgery were included in the study. All subjects underwent best corrected visual acuity (BCVA) evaluation using the ETDRS optotype in photopic and scotopic conditions, and contrast sensitivity (CS) assessment using the CSV 1000 and the Pelli Robson tests in different lighting conditions, preoperatively, at 1 and 6 months after surgery. Fourteen eyes of 14 healthy controls were evaluated using the same protocol and compared with the patients’ final postsurgery data.ResultsResults: A significant improvement in all visual function parameters was observed in patients 1 month (p < 0.05) and 6 months (p < 0.05) after DMEK, compared with preoperative levels. Healthy controls had significantly higher BCVA in photopic and scotopic conditions (p = 0.02, p = 0.044, respectively), better CS in spatial frequencies of 6 cpd (p < 0.001); 12 cpd (p = 0.006) and 18 cpd (p = 0.006) measured with the CSV 1000 test, and CS as measured with the Pelli Robson test (p = 0.002). No significant differences were observed between patients and healthy controls in the spatial frequency of 3 cpd (photopic, p = 0.704; mesopic, p = 0.596; mesopic with glare, p = 0.989).ConclusionsConclusions: DMEK improves visual function parameters in patients with FED in the first month after surgery. Patients who underwent DMEK present similar CS to healthy subjects in lower frequencies. However, BCVA and CS in medium and high frequencies remain significantly lower than those values found in healthy corneas.