Corneal Optical Changes Associated with Induced Edema in Fuchs Endothelial Corneal Dystrophy

Katrin Wacker, Jay W. McLaren, Katrina M. Kane, Sanjay V. Patel

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

PURPOSE: Patients with Fuchs endothelial corneal dystrophy (FECD) often notice poor vision in the morning that improves as the day progresses. In this study, we determined changes in corneal optical properties associated with induced corneal edema.

METHODS: Twenty-three phakic eyes (23 participants) with FECD (grades 1-6, modified Krachmer scale) and 8 normal eyes (8 participants) were examined by Scheimpflug photography. Central corneal thickness, high-order aberrations from anterior and posterior corneal surfaces, and backscatter from the anterior, mid-, and posterior cornea were determined from the Scheimpflug images. A low-oxygen permeable contact lens was placed on the eye, and eyes were closed for 2 hours, after which the lens was removed and Scheimpflug photography was repeated for up to 5 hours to determine changes in backscatter and high-order aberrations.

RESULTS: Corneas swelled by 10% [95% confidence interval (CI), 9-10]. Backscatter from the anterior cornea increased by 416 scatter units (SU, 95% CI, 344-488; P < 0.001), independent of the presence and severity of FECD. Recovery of anterior backscatter was slower in advanced FECD (81 SU/h, 95% CI, 60-120) compared with normal (123 SU/h, 95% CI, 95-150; P = 0.019). Anterior and posterior corneal high-order aberrations, and mid and posterior backscatter, did not increase with induced swelling.

CONCLUSIONS: Inducing corneal edema increases anterior corneal backscatter but not high-order aberrations. Subjective poor vision in the morning in FECD is probably caused by scattered light rather than by high-order aberrations, suggesting that these patients experience more disability glare than decreased visual acuity.

Original languageEnglish (US)
Pages (from-to)313-317
Number of pages5
JournalCornea
Volume37
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Fuchs' Endothelial Dystrophy
Edema
Confidence Intervals
Cornea
Corneal Edema
Photography
Glare
Contact Lenses
Lenses
Visual Acuity
Oxygen
Light

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Corneal Optical Changes Associated with Induced Edema in Fuchs Endothelial Corneal Dystrophy. / Wacker, Katrin; McLaren, Jay W.; Kane, Katrina M.; Patel, Sanjay V.

In: Cornea, Vol. 37, No. 3, 01.03.2018, p. 313-317.

Research output: Contribution to journalArticle

Wacker, Katrin ; McLaren, Jay W. ; Kane, Katrina M. ; Patel, Sanjay V. / Corneal Optical Changes Associated with Induced Edema in Fuchs Endothelial Corneal Dystrophy. In: Cornea. 2018 ; Vol. 37, No. 3. pp. 313-317.
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N2 - PURPOSE: Patients with Fuchs endothelial corneal dystrophy (FECD) often notice poor vision in the morning that improves as the day progresses. In this study, we determined changes in corneal optical properties associated with induced corneal edema.METHODS: Twenty-three phakic eyes (23 participants) with FECD (grades 1-6, modified Krachmer scale) and 8 normal eyes (8 participants) were examined by Scheimpflug photography. Central corneal thickness, high-order aberrations from anterior and posterior corneal surfaces, and backscatter from the anterior, mid-, and posterior cornea were determined from the Scheimpflug images. A low-oxygen permeable contact lens was placed on the eye, and eyes were closed for 2 hours, after which the lens was removed and Scheimpflug photography was repeated for up to 5 hours to determine changes in backscatter and high-order aberrations.RESULTS: Corneas swelled by 10% [95% confidence interval (CI), 9-10]. Backscatter from the anterior cornea increased by 416 scatter units (SU, 95% CI, 344-488; P < 0.001), independent of the presence and severity of FECD. Recovery of anterior backscatter was slower in advanced FECD (81 SU/h, 95% CI, 60-120) compared with normal (123 SU/h, 95% CI, 95-150; P = 0.019). Anterior and posterior corneal high-order aberrations, and mid and posterior backscatter, did not increase with induced swelling.CONCLUSIONS: Inducing corneal edema increases anterior corneal backscatter but not high-order aberrations. Subjective poor vision in the morning in FECD is probably caused by scattered light rather than by high-order aberrations, suggesting that these patients experience more disability glare than decreased visual acuity.

AB - PURPOSE: Patients with Fuchs endothelial corneal dystrophy (FECD) often notice poor vision in the morning that improves as the day progresses. In this study, we determined changes in corneal optical properties associated with induced corneal edema.METHODS: Twenty-three phakic eyes (23 participants) with FECD (grades 1-6, modified Krachmer scale) and 8 normal eyes (8 participants) were examined by Scheimpflug photography. Central corneal thickness, high-order aberrations from anterior and posterior corneal surfaces, and backscatter from the anterior, mid-, and posterior cornea were determined from the Scheimpflug images. A low-oxygen permeable contact lens was placed on the eye, and eyes were closed for 2 hours, after which the lens was removed and Scheimpflug photography was repeated for up to 5 hours to determine changes in backscatter and high-order aberrations.RESULTS: Corneas swelled by 10% [95% confidence interval (CI), 9-10]. Backscatter from the anterior cornea increased by 416 scatter units (SU, 95% CI, 344-488; P < 0.001), independent of the presence and severity of FECD. Recovery of anterior backscatter was slower in advanced FECD (81 SU/h, 95% CI, 60-120) compared with normal (123 SU/h, 95% CI, 95-150; P = 0.019). Anterior and posterior corneal high-order aberrations, and mid and posterior backscatter, did not increase with induced swelling.CONCLUSIONS: Inducing corneal edema increases anterior corneal backscatter but not high-order aberrations. Subjective poor vision in the morning in FECD is probably caused by scattered light rather than by high-order aberrations, suggesting that these patients experience more disability glare than decreased visual acuity.

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