Gundlach Enken, Pilger Daniel, Brockmann Tobias, Dietrich-Ntoukas Tina, Joussen Antonia M, Torun Necip, Maier Anna-Karina B
Department of Ophthalmology, Campus Virchow-Klinikum, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany; and.
Department of Ophthalmology, Universitätsmedizin Rostock, Berlin, Germany.
Cornea. 2021 Sep 1;40(9):1110-1116. doi: 10.1097/ICO.0000000000002686.
To study the change in contrast sensitivities in eyes with Fuchs endothelial dystrophy and bullous keratopathy after Descemet membrane endothelial keratoplasty (DMEK).
In this prospective study, 50 pseudophakic eyes of 50 patients who received DMEK surgery at the Charité-Universitätsmedizin Berlin were included. Visual acuity; contrast sensitivity using OPTEC 6500 at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles/degree in photopic and mesopic light with and without glare; central corneal thickness (CCT); and anterior and posterior corneal aberrations were measured preoperatively and at 3 and 12 months postoperatively.
Best-corrected visual acuity (preoperative 0.67 ± 0.46 and after 12 months 0.19 ± 0.16 LogMAR, P < 0.001) and photopic and mesopic contrast sensitivities with and without glare improved significantly, whereas CCT decreased significantly (preoperative 677 ± 114 μm, after 12 months 527 ± 29 μm, P < 0.001). Preoperative CCT correlates significantly with preoperative photopic contrast sensitivity (correlation coefficient -0.462, P = 0.002), and postoperative total anterior aberrations correlates with postoperative photopic contrast sensitivity (correlation coefficient -0.361, P = 0.006).
Photopic and mesopic contrast sensitivities, especially with glare, are impaired in patients with Fuchs endothelial dystrophy and bullous keratopathy. The extent of the corneal thickening seems to mainly influence the contrast sensitivity preoperatively. DMEK surgery improves the contrast sensitivity significantly. However, higher postoperative anterior corneal aberrations limit the postoperative contrast sensitivities.
研究接受Descemet膜内皮角膜移植术（DMEK）后，Fuchs内皮营养不良和大疱性角膜病变患者的对比敏感度变化。
在这项前瞻性研究中，纳入了在柏林夏里特大学医学中心接受DMEK手术的50例患者的50只人工晶状体眼。测量术前、术后3个月和12个月时的视力；使用OPTEC 6500在明视和暗视条件下，有眩光和无眩光时，空间频率为1.5、3、6、12和18周/度的对比敏感度；中央角膜厚度（CCT）；以及角膜前后表面像差。
最佳矫正视力（术前0.67±0.46，12个月后为0.19±0.16 LogMAR，P<0.001）以及有眩光和无眩光时的明视和暗视对比敏感度均显著提高，而CCT显著降低（术前677±114μm，12个月后527±29μm，P<0.001）。术前CCT与术前明视对比敏感度显著相关（相关系数-0.462，P = 0.002），术后总前表面像差与术后明视对比敏感度相关（相关系数-0.361，P = 0.006）。
Fuchs内皮营养不良和大疱性角膜病变患者的明视和暗视对比敏感度受损，尤其是存在眩光时。术前角膜增厚程度似乎主要影响对比敏感度。DMEK手术显著提高了对比敏感度。然而，术后较高的角膜前表面像差限制了术后对比敏感度。
