Identifying predictive factors for long-term visual recovery after corneal endothelial keratoplasty in Fuchs' dystrophy: Potential interaction between the corneal dysfunction and retinal status

IntroductionDescemet 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. MethodsWe 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. ResultsPostoperative BCVA after 1 year was 0.20 +/- 0.18 logMAR. Logistic regression revealed that good visual recovery correlated negatively with preoperative central macular thickness (p < 0.001) and the need for rebubbling (p = 0.05), and positively with preoperative visual acuity (p = 0.009). Multivariate formula to predict the 1-year BCVA has been suggested. DiscussionPreoperative 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.

Automated summary

This study aimed to identify the predictive factors for visual recovery after Descemet membrane endothelial keratoplasty (DMEK) in Fuchs' dystrophy (FECD) patients. The results showed that preoperative retinal status was the main factor predicting long-term visual outcome. This information can assist in informing patients about prognosis and adjusting therapeutic strategies, highlighting the collaboration between cornea and retina subspecialists.