Impact of DMEK on visual quality in patients with Fuchs' endothelial dystrophy.

PURPOSE: To investigate short-term (3 months follow-up) changes in visual quality following Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy (FED). METHODS: 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). RESULTS: 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 (rs = 0.39; P = 0.03) and frequency (rs = 0.26; P = 0.02) as well as severity (rs = 0.27; P = 0.03) of blurry vision. CDVA and central corneal thickness (CCT) did not correlate with visual complains. CONCLUSIONS: 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.

Pupil size measurements with a multifunctional aberrometer/coherence interferometer/tomographer and two infrared-based pupillometers.

PURPOSE: To compare precision of pupil size measurements of a multifunctional device (Pentacam AXL Wave [Pentacam]) and 2 infrared-based pupillometers (PupilX, Colvard) and to compare repeatability of Pentacam and PupilX. SETTING: Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany. DESIGN: Prospective, comparative trial. METHODS: Pupil diameter of healthy eyes was measured with Colvard once and Pentacam without glare (WO) and with glare (WG), PupilX in 0, 1, and 16 lux 3 times each. In a second series, measurements with Pentacam WO and PupilX in 0.06 and 0.12 lux were assessed. RESULTS: 36 eyes of participants aged 21 to 63 years were included. Mean pupil diameter was 6.05 mm with Colvard, 5.79 mm (first series), 5.50 mm (second series) with Pentacam WO, 3.42 mm WG, 7.26 mm PupilX in 0, 4.67 mm 1, 3.66 mm 16, 6.82 mm in 0.06, and 6.39 mm in 0.12 lux. Measurements with Pentacam WO were significantly different to PupilX in 0, 0.06, 0.12, and 1 lux (all P < .001), but not to Colvard ( P = .086). Pupil size measured with Pentacam WG and PupilX in 16 lux was not significantly different ( P = .647). Consecutive measurements with Pentacam WO and WG had mean SD of 0.23 mm and 0.20 mm, respectively, and with PupilX 0.11 in 0, 0.24 mm 1, and 0.20 mm in 16 lux. CONCLUSIONS: Pentacam provided good assessment of pupil size but was not equivalent to PupilX in low lighting conditions. Repeatability was more favorable for Pentacam.