Titel | Cataract surgery in Fuchs endothelial dystrophy |
Doel | To evaluate the use of preoperative parameters in patients with Fuchs’ endothelial dystrophy (FED) who are undergoing cataract surgery to predict the need for future endothelial keratoplasty (EK). |
Methodes | Eighty-nine patients (89 eyes) with FED undergoing cataract extraction were included in this study. Best corrected visual acuity (BCVA), slit lamp examination, ultrasound pachymetry, Pelli-Robson contrast sensitivity chart, C-Quant Straylight Meter and In Vivo Confocal Microscopy (IVCM) were assessed preop and 1, 2 and 12 months postop. All parameters were compared to the eventual progression into EK. |
Resultaten | LogMAR BCVA improved from a mean of 0,33 (range -0,12 to 0,9) before cataract surgery to 0,26 (range -0,16 to 0,92) at 2 months postop. In 36 (40,5%) eyes, EK was performed between 2 and 12 months postop. Logistic regression analysis of pre- and intraop parameters defined ultrasound pachymetry (p=0,010), Subepithelial peak (p=0,00052) and Epithelial valley (p=0,00056) on the IVCM backscatter profile as the 3 variables related to postop progression into EK. |
Conclusie | According to past publications, pachymetry can be used as a predictor of corneal decompensation after cataract surgery in FED. A preop pachymetry of > 606 microns is predictive of corneal decompensation, and a combined cataract extraction with endothelial keratoplasty may be considered. We defined the Subepithelial peak and Epithelial valley on the IVCM backscatter profile as 2 additional predictors of postop decompensation with a better sensitivity and specificity compared to pachymetry. |
Naam | VAN CLEYNENBREUGEL |
Initialen | H |
Instituut | The Rotterdam Eye Hospital |
Stad | Rotterdam, The Netherlands |
Naam | Remeijer |
Initialen | L |
Instituut | The Rotterdam Eye Hospital |
Stad | Rotterdam, The Netherlands |
Naam | Hillenaar |
Initialen | T |
Instituut | The Rotterdam Eye Hospital |
Stad | Rotterdam, The Netherlands |