title: Changes in color vision and contrast sensitivity after descemet membrane endothelial keratoplasty for fuchs endothelial dystrophy.
abstract: OBJECTIVE
  The aim of this study is to evaluate contrast sensitivity, color vision, and subjective patient satisfaction after Descemet membrane endothelial keratoplasty (DMEK) in patients with bilateral Fuchs endothelial dystrophy (FED).
  
  
  METHODS
  From a group of 500 DMEK surgeries performed in our center, patients with a history of bilateral FED and unilateral DMEK were identified. A total of 29 patients were included in the study and divided into 2 groups: phakic (n = 12) and pseudophakic unilateral DMEK (n = 17) and their contralateral, untreated FED-affected eye. In addition, a control group of 10 healthy eyes of 10 patients was included. Pelli-Robson contrast sensitivity and Farnsworth-Munsell 100 hue color vision tests were performed. Subjective optical quality was graded with a questionnaire.
  
  
  RESULTS
  Compared with untreated FED-affected eyes, best spectacle-corrected visual acuity was higher after DMEK in phakic and pseudophakic eyes (P = 0.030 and P < 0.001, respectively); a similar result was obtained for contrast sensitivity (P < 0.001 and P < 0.001, respectively). Color vision did not differ between untreated FED-affected and DMEK-operated eyes in the phakic group (P = 0.802) and the pseudophakic group (P = 0.227). Subjective optical quality was better in DMEK-operated eyes than in untreated FED-affected eyes in the phakic group (P < 0.001) and in the pseudophakic group (P < 0.001).
  
  
  CONCLUSIONS
  In FED, DMEK may not only be effective for obtaining a higher visual acuity but particularly improving the contrast sensitivity may also lead to better subjective optical performance. Although frequently mentioned spontaneously by patients, an objective change in color vision could not be substantiated. Hence, quantifying contrast sensitivity before surgery may aid in the decision for surgery, and in the evaluation of surgical outcome.
authors.affiliation: *Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands; †Department of Ophthalmology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain; ‡Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands; and §Amnitrans Eye Bank Rotterdam, Rotterdam, the Netherlands.
authors.forename: Javier
authors.initials: J
authors.lastname: Cabrerizo
authors.forename: Eitan
authors.initials: E
authors.lastname: Livny
authors.forename: Fayyaz U
authors.initials: FU
authors.lastname: Musa
authors.forename: Paulien
authors.initials: P
authors.lastname: Leeuwenburgh
authors.forename: Korine
authors.initials: K
authors.lastname: van Dijk
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003119:Color Perception Tests; D055253:Color Vision / Q000502:physiology*; D015350:Contrast Sensitivity / Q000502:physiology*; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology