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    DMEK associated with better visual quality

    Study compared functional vision outcomes of DMEK versus DSAEK


    Dr. Straiko also has anecdotal reports of patients who favor their DMEK or DSAEK-treated eye, even if visual acuity is not as strong as their fellow untreated Fuchs’ dystrophy eye. He assumes that this must be explained by the quality of vision.

    In the current study investigators identified 11 patients with DSAEK in one eye, DMEK in the fellow eye, and no visual limiting comorbidities. These patients then underwent further prospective visual quality testing with the Functional Visual analyzer. All patients had undergone a successful DMEK transplant in one eye and a successful DSAEK transplant in the fellow eye for Fuchs’ dystrophy. Patients had an average age of about 70 years old with similar preoperative visual acuity and central corneal thickness. Patients with dry eye with corneal staining or unstable tear film were not included.

    Patients took part in an Institutional Review Board-approved study to test contrast sensitivity with the use of the Functional Vision Analyzer under varied, and precisely controlled, lighting conditions.

    “Contrast sensitivity was evaluated at various levels of contrast and varied spatial frequencies,” the investigators reported in their abstract.

    Patients also filled out a Quality of Vision (QoV) questionnaire to measure adverse visual symptoms in each eye.

    In the 11 patients, investigators found that eyes with a DMEK transplant had significantly better contrast sensitivity than DSAEK-transplanted eyes.

    “Patient scores from the QoV questionnaire indicate that the DMEK transplants trended toward lower frequency, severity, and less bothersome adverse visual symptoms than DSAEK transplanted eyes,” the investigators reported.

    Investigators asked patients if they had an accident and could only keep one eye, which eye they would want to keep. Seventy-five percent would want to keep the DMEK eye.

    “For others, it may have been an ocular dominance preference,” Dr. Straiko said.

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