Outcomes of cataract surgery in patients with Fuchs’ endothelial corneal dystrophy

Session Details

Session Title: Cataract Surgery: Special Cases

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 08:30

Venue: Free Paper Forum: Podium 2

First Author: : E.Malandain FRANCE

Co Author(s): :    J. Gueudry   G. Boutillier   M. Muraine                       

Abstract Details

Purpose:

To evaluate the surgical outcomes of eyes with Fuchs’ endothelial corneal dystrophy (FECD) undergoing cataract surgery alone, to ascertain preoperative factors that predict the need for endothelial keratoplasty (EK).

Setting:

Retrospective, observational cohort study, between March 2014 and April 2017, Rouen university hospital, France.

Methods:

Cataract surgery alone was performed in 64 eyes of 50 patients with FECD. This decision was made if the patient did not have morning blur and a central corneal thickness (CCT) below 630 microns. Patients who did not fulfill these criteria directly benefited from combined cataract surgery and EK (triple procedure) and were therefore excluded from the study. CCT and best corrected visual acuity before and after cataract surgery, endothelial cell loss, and the postoperative need for EK (performed in cases of insufficient recovery) in these eyes were assessed.

Results:

Mean follow-up was 21 months (range 5 – 55 months). The mean preoperative visual acuity was 0.39 +/- 0.18 LogMAR and 0.17 +/- 0.15 LogMAR at 3 months postoperatively (p < 0.001). The mean preoperative CCT was 571 +/- 43 μm. 3 months after surgery, it was 584 +/- 52 μm (p= 0.12). During follow-up, 14 eyes (22%) required an EK because of poor visual outcome after cataract surgery alone. Mean pre-operative CCT of these eyes (595 +/-23 μm) was significantly higher than eyes that did not require EK during follow-up (564 +/- 45 μm, p= 0.002).

Conclusions:

CCT below 630 μm associated with the absence of a morning blur are preoperative criteria allowing 78% eyes with FECD to obtain good visual outcomes after cataract surgery alone. In these eyes, EK can therefore be avoided while ensuring good results.

Financial Disclosure:

None