Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Department of Ophthalmology, LMU, Mathildenstraße 8, 80336, Munich, Germany.
Graefes Arch Clin Exp Ophthalmol. 2022 Feb;260(2):521-528. doi: 10.1007/s00417-021-05334-6. Epub 2021 Sep 16.
To investigate short-term (3 months follow-up) changes in visual quality following Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy (FED).
In this prospective institutional case series, 51 patients that underwent DMEK for FED were included. Assessment included the Quality of Vision (QoV) questionnaire preoperatively, at 1 month, and 3 months after surgery. Secondary outcome measures were anterior segment parameters acquired by Scheimpflug imaging, corrected distance visual acuity (CDVA), and endothelial cell density (ECD).
Glare, hazy vision, blurred vision, and daily fluctuation in vision were the symptoms mostly reported preoperatively. All symptoms demonstrated a significant reduction of item scores for severity, frequency, and bothersome in the course after DMEK (P < 0.01). Glare and fluctuation in vision remained to some extent during the follow-up period (median score = 1). Preoperatively, corneal densitometry correlated moderately to weakly with severity of hazy vision (r = 0.39; P = 0.03) and frequency (r = 0.26; P = 0.02) as well as severity (r = 0.27; P = 0.03) of blurry vision. CDVA and central corneal thickness (CCT) did not correlate with visual complains.
Following DMEK for FED, patient-reported visual symptoms assessed by the QoV questionnaire represent a useful tool providing valuable information on the impact of DMEK on visual quality that cannot be directly estimated by morphological parameters and visual acuity only.
研究行 Descemet 膜内皮角膜移植术（DMEK）治疗 Fuchs 内皮营养不良（FED）后短期（3 个月随访）视觉质量的变化。
本前瞻性机构病例系列研究纳入了 51 例行 DMEK 治疗 FED 的患者。评估包括术前、术后 1 个月和 3 个月的视觉质量（QoV）问卷。次要观察指标包括Scheimpflug 成像获得的眼前节参数、矫正远视力（CDVA）和内皮细胞密度（ECD）。
畏光、视物模糊、视力模糊和视力日常波动是术前报告的主要症状。所有症状在 DMEK 后（P < 0.01）严重程度、频率和困扰程度的项目评分均显著降低。术后随访期间，畏光和视力波动仍在一定程度上存在（中位数评分=1）。术前角膜密度与视物模糊的严重程度（r=0.39；P=0.03）和频率（r=0.26；P=0.02）以及视物模糊的严重程度（r=0.27；P=0.03）呈中度至弱相关。CDVA 和中央角膜厚度（CCT）与视觉主诉无关。
FED 行 DMEK 后，QoV 问卷评估的患者报告视觉症状是一种有用的工具，可提供有关 DMEK 对视觉质量影响的有价值信息，而这些信息不能仅通过形态参数和视力来直接估计。
