Assessment Of Tomographic Parameters And Detection Of Subclinical Edema In Fuchs Endothelial Corneal Dystrophy Pre-Cataract Surgery
Published 2024 - 42nd Congress of the ESCRS
Reference: FP19.01 | Type: Free paper | DOI: 10.82333/2w3t-t529
Authors: João Alves Ambrósio* 1 , Catarina Pestana Aguiar 1 , Pedro Cardoso Teixeira 1 , João Chibante Pedro 1 , Inês Almeida 1
1Ophthalmology,Centro Hospitalar de Entre o Douro e Vouga,Santa Maria da Feira,Portugal
Purpose
This study aims to overcome the subjective limitations of conventional biomicroscopy and the inconsistent detection by corneal specular microscopy (CSM) in evaluating Fuchs Endothelial Corneal Dystrophy (FECD) severity pre-cataract surgery. Utilizing Scheimpflug tomography, the research seeks to objectively assess tomographic changes and the presence of subclinical corneal edema in FECD patients, thus providing a more reliable diagnostic tool for monitoring disease progression and predicting corneal decompensation.
Setting
Department of Ophthalmology, Unidade Local de Saúde Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Methods
A cross-sectional study was conducted on 30 phakic eyes from patients diagnosed with FECD but without clinical edema, and 59 phakic eyes from a control group without corneal alterations. Comprehensive ophthalmic examinations were conducted, including slit-lamp biomicroscopy, CSM, and Scheimpflug tomography.
Results
Scheimpflug tomography revealed significant tomographic changes in FECD eyes, underscoring the utility of this technique in detecting subtle, yet critical, changes compared to controls. Parameters such as the loss of parallel isopachs (13 vs. 0 eyes, p < 0.001), displacement of the thinnest point (11 vs. 0 eyes, p < 0.001), posterior focal depression (25 vs. 7 eyes, p < 0.001), and increased light scatter (21.4 [17.6; 23.9] vs. 18.0 [16.8; 21.8], p = 0.01) were significantly more prevalent in FECD eyes, reflecting the presence of subclinical edema and loss of corneal transparency.
Conclusions
Scheimpflug tomography provides an objective and effective method for assessing FECD severity, capable of detecting subclinical edema and tomographic changes not observable with traditional biomicroscopy or CSM. This technology offers valuable insights for early detection, monitoring disease progression, and predicting outcomes post-cataract surgery in FECD patients, highlighting its importance in clinical practice.