Maffre Charlotte, Fournié Pierre, Durbant Eve, Arndt Carl, Djerada Zoubir, Denoyer Alexandre
University of Reims Champagne-Ardenne, Reims, France.
University Hospital Robert Debré, Reims, France.
Front Med (Lausanne). 2023 Mar 9;10:1120283. doi: 10.3389/fmed.2023.1120283. eCollection 2023.
Descemet membrane endothelial keratoplasty (DMEK) is the main treatment for Fuchs' dystrophy (FECD). The outcomes are excellent, but the final visual recovery may vary from patient to patient with sometimes no obvious reason of such a spread.
We conducted a clinical prospective multicentric study to identify the predictive factors for the visual result 1 year after surgery. Eighty three patients (83 eyes) were included.
Postoperative BCVA after 1 year was 0.20 ± 0.18 logMAR. Logistic regression revealed that good visual recovery correlated negatively with preoperative central macular thickness ( < 0.001) and the need for rebubbling ( = 0.05), and positively with preoperative visual acuity ( = 0.009). Multivariate formula to predict the 1-year BCVA has been suggested.
Preoperative retinal status seems to be the main predictive factor for long-term visual result after DMEK. Our predictive multivariate model could assist in better informing the patient about the prognosis of the surgery, and in adjusting the therapeutic strategy also, further highlighting the essential collaboration between both cornea and retina subspecialists.
Descemet膜内皮角膜移植术（DMEK）是富克斯角膜内皮营养不良（FECD）的主要治疗方法。手术效果良好，但最终视力恢复情况因人而异，有时这种差异并无明显原因。
我们开展了一项临床前瞻性多中心研究，以确定术后1年视力结果的预测因素。纳入了83例患者（83只眼）。
术后1年的最佳矫正视力（BCVA）为0.20±0.18 logMAR。逻辑回归显示，良好的视力恢复与术前中心黄斑厚度呈负相关（<0.001），与再次注气需求呈负相关（=0.05），与术前视力呈正相关（=0.009）。已提出预测1年BCVA的多变量公式。
术前视网膜状态似乎是DMEK术后长期视力结果的主要预测因素。我们的预测多变量模型有助于更好地向患者告知手术预后，并调整治疗策略，进一步凸显角膜和视网膜亚专科医生之间的重要协作。
