Vision and Quality of Life in Fuchs' Endothelial Dystrophy Using a Prototype Aberrometer: A Cross-Sectional Study

Area of Science:

• Ophthalmology
• Corneal Diseases
• Visual Function

Background:

• Fuchs' endothelial corneal dystrophy (FECD) is a progressive condition impacting vision and quality of life (QoL).
• Assessing visual function typically relies on best distance-corrected visual acuity (BDCVA), but the influence of optical aberrations and advanced imaging on patient outcomes is not fully understood.

Purpose of the Study:

• To investigate the interrelationships between clinical, optical, and QoL parameters in patients diagnosed with FECD.
• To determine if advanced optical metrics enhance the prediction of patient-reported outcomes in FECD.

Main Methods:

• A prospective, cross-sectional study involving ophthalmic evaluations including BDCVA, refraction, corneal thickness, endothelial cell density (ECD), and aberrometry.
• Clinical grading of FECD severity using the modified-Krachmer scale and classification based on corneal edema, pigment, or fibrosis.
• Quality of life assessment using the NEI Visual Function Questionnaire (VFQ-25) with correlational analyses.

Main Results:

• Corneal edema and fibrosis were significantly associated with worse BDCVA.
• The modified-Krachmer scale strongly correlated with BDCVA and moderately with wavefront metrics (RMS).
• The VFQ-25 total score showed the strongest correlation with the visual acuity of the worse eye.

Conclusions:

• Worse-eye BDCVA is a significant correlate of patient-reported QoL in FECD.
• High-resolution optical metrics did not substantially improve the prediction of patient experience beyond clinical variables.
• Current advanced optical metrics are insufficient for reliably predicting the subjective patient experience in FECD.