title: Visual acuity and contrast sensitivity following Descemet stripping automated endothelial keratoplasty.
abstract: OBJECTIVE
  To describe improvements in visual acuity and contrast sensitivity following Descemet stripping automated endothelial keratoplasty (DSAEK).
  
  
  METHODS
  We analysed 128 consecutive patients (128 eyes) with Fuchs endothelial dystrophy (FED) and bullous keratopathy (BK) who underwent DSAEK at a single tertiary referral centre from January 2006 to September 2009. Our main outcome measures were best-corrected visual acuity (BCVA) and contrast sensitivity over 24 months follow-up.
  
  
  RESULTS
  Median age was 67 (60-73) years with 55% women (n=70) and majority Chinese (74%, n=94) in our Asian population. There were no significant differences between demographics between the FED (48%, 61 eyes) and BK (52%, 67 eyes) groups. Forward multivariate linear regression adjusted for age, gender, donor graft thickness and diagnosis (FED vs BK) revealed that preoperative visual acuity was the most significant factor associated with visual acuity at 1 year (B=0.032, p=0.03, R(2)=0.122). Visual recovery was longer in eyes with BK, with a significantly better visual acuity in the FED group at 12 months (mean logarithm of the minimum angle of resolution BCVA BK: 0.27±0.1 vs FED: 0.22±0.9; p=0.001), but not significant at 24 months (p=0.154). Contrast sensitivity significantly improved more in the first 6 months in the FED when compared with the BK group (at 3.0, 6.0 and 12.0 cycles per degree, p<0.01).
  
  
  CONCLUSIONS
  Our study suggests that while there was significant improvement in contrast sensitivity and visual acuity after DSAEK, poor preoperative visual acuity was associated with an inferior visual outcome and the time to recovery was longer in eyes with BK.
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Fiona
authors.initials: F
authors.lastname: Lim
authors.affiliation: Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Hla M
authors.initials: HM
authors.lastname: Htoon
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, National University Health System, Singapore, Singapore Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Donald
authors.initials: D
authors.lastname: Tan
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000368:Aged; D001768:Blister / Q000503:physiopathology / Q000601:surgery*; D015350:Contrast Sensitivity / Q000502:physiology*; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*
keywords: Cornea; Vision