External Validation Of A Clinical Score For Predicting The Need Of Endothelial Keratoplasty After Cataract Surgery In Fuchs Endothelial Dystrophy

Published 2024 - 42nd Congress of the ESCRS

Reference: FP31.06 | Type: Free paper | DOI: 10.82333/1jgq-0w35

Authors: Francisco Arnalich* ¹

¹Hospital Universitario Ramón y Cajal,Madrid,Spain

Purpose

The SUbClinical Corneal Edema Scheimplug Study Score (SUCCESS Score),derived from a single center study, prognosticates the need for endothelial keratoplasty (EK) after cataract surgery in patients with Fuchs Endothelial Corneal Dystrophy(FECD). This study aimed to externally validate the score, that was published in a single center study.

Setting

Multicentric study in 5 Spanish Tertiary Hospitals.

Methods

The SUCCESS score was externally validated in a prospective, multicentric study with 137 patients. Patient with FECD had cataract surgery, and after the surgery, during a follow up of at least 1 year, they were recommended or not to have EK, based on their visual function. SUCCESS score included the number of tomographic features present regarded as compatible with subclinical corneal edema as defined by Sun et al and a categorized central corneal thickness, obtaining a total score ranging from 0 to 8 points.

Results

In total, EK was needed in 32 (26.5 %) patients. Based on the SUCCESS SCORE, 50 % of patients were classified as low risk (0-4 points), 25 % were classified as intermediate risk (5-6 points), 25 % were classified as high risk (>7 points). Discrimination (C-index 0.80, 95% CI 0.76-0.82) was good and calibration (calibration slope 0.51, 95% CI 0.34-0.65) was moderate. Stratified calibration analyses showed that the model overestimated the risk of EK among individuals who were classified at high risk, but not in the low or intermediate risk.

Conclusions

The SUCCESS Score provided good discrimination but suboptimal calibration in high-risk patients.