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

Charlotte Maffre; Pierre Fournié; Eve Durbant; Carl Arndt; Zoubir Djerada; Alexandre Denoyer

doi:10.3389/fmed.2023.1120283

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

Front Med (Lausanne). 2023 Mar 9:10:1120283. doi: 10.3389/fmed.2023.1120283. eCollection 2023.

Authors

Charlotte Maffre^{1

2}, Pierre Fournié³, Eve Durbant², Carl Arndt^{1

2}, Zoubir Djerada^{1

2}, Alexandre Denoyer^{1

2

4}

Affiliations

¹ University of Reims Champagne-Ardenne, Reims, France.
² University Hospital Robert Debré, Reims, France.
³ University of Toulouse III Paul Sabatier, Toulouse, France.
⁴ CARDIOVIR Research Team, EA-4684, University of Reims Champagne-Ardenne, Reims, France.

Abstract

Introduction: 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.

Methods: 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.

Results: 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 (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.

Discussion: 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.

Keywords: Descemet membrane endothelial keratoplasty; Fuchs; cornea; cornea guttata; predictive model.