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Presentation typeOB - oral
TitleCataract surgery in Fuchs endothelial dystrophy
PurposeTo 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).
MethodsEighty-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.
ResultsLogMAR 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.
ConclusionAccording 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.
Author 1
Last nameVAN CLEYNENBREUGEL
InitialsH
DepartmentThe Rotterdam Eye Hospital
CityRotterdam, The Netherlands
Author 2
Last nameRemeijer
InitialsL
DepartmentThe Rotterdam Eye Hospital
CityRotterdam, The Netherlands
Author 3
Last nameHillenaar
InitialsT
DepartmentThe Rotterdam Eye Hospital
CityRotterdam, The Netherlands
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