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Buzzi M, Carnicci A, Maccari M, Magherini S, Patel SV, Virgili G, Giansanti F, Mencucci R. Validation of the Italian Version of the Visual Function and Corneal Health Status (V-FUCHS) Questionnaire: A Patient-Reported Visual Disability Instrument for Fuchs' Endothelial Corneal Dystrophy. J Clin Med 2025; 14:3996. [PMID: 40507755 PMCID: PMC12155578 DOI: 10.3390/jcm14113996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2025] [Revised: 05/30/2025] [Accepted: 06/04/2025] [Indexed: 06/16/2025] Open
Abstract
Background/Objectives: The Visual Function and Corneal Health Status (V-FUCHS) questionnaire assesses vision-related quality of life in patients affected by Fuchs endothelial corneal dystrophy (FECD) through 15 items, which are divided into the "visual acuity (VA) Factor" and "glare Factor" domains. The purpose of this study was to translate and validate the Italian version of the V-FUCHS instrument. Methods: The original V-FUCHS questionnaire was translated into Italian using certified forward and backward translation methods and administered to patients with FECD undergoing a unilateral or bilateral Descemet membrane endothelial keratoplasty (DMEK) for FECD and healthy controls. Its test-retest reliability was assessed by administering the questionnaire twice, four weeks apart. Modified Krachmer grade, best-corrected visual acuity (BCVA) and central corneal thickness (CCT) were also measured. Results: A total of 74 participants, aged 45 to 83 years, were prospectively enrolled and divided into five subgroups: mild-to-moderate FECD (n = 18), advanced FECD (n = 15), unilateral DMEK (n = 9), bilateral DMEK (n = 12), and healthy controls (n = 20). Retest reliability confirmed the consistency and agreement of their responses (intraclass correlation coefficient > 0.90 for both factors). The Italian V-FUCHS effectively discriminated between different stages of FECD severity, with significant differences in VA and glare factor scores across all subgroups (p < 0.001). While both BCVA and CCT showed correlations with V-FUCHS scores, only the association between the VA factor and BCVA was statistically significant (p < 0.05), indicating that the VA factor meaningfully reflects patients' measured VA. Conclusions: The proposed Italian version of the V-FUCHS questionnaire is a valid and reliable tool for assessing visual disability in patients with FECD before and after DMEK. This instrument may aid in optimizing endothelial keratoplasty timings and evaluating postoperative symptomatic improvements in FECD patients.
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Affiliation(s)
- Matilde Buzzi
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
| | - Alberto Carnicci
- Unit of Ophthalmology, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy;
| | - Martina Maccari
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
| | - Silvia Magherini
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
| | - Sanjay V. Patel
- Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA;
| | - Gianni Virgili
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
| | - Fabrizio Giansanti
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
| | - Rita Mencucci
- Eye Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (M.M.); (S.M.); (G.V.); (F.G.); (R.M.)
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Yokogawa H, Hayashi T, Kobayashi A, Mori N, Yamazaki K, Ohta H, Takeda M, Igarashi A, Yamagami S. Descemet membrane endothelial keratoplasty after cataract surgery with presbyopia-correcting intraocular lens for coexisting Fuchs endothelial corneal dystrophy and cataract. Jpn J Ophthalmol 2025:10.1007/s10384-025-01215-1. [PMID: 40418490 DOI: 10.1007/s10384-025-01215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 03/23/2025] [Indexed: 05/27/2025]
Abstract
PURPOSE To assess the outcomes of Descemet membrane endothelial keratoplasty (DMEK) staged after implantation of presbyopia-correcting intraocular lenses (IOLs) in patients with coexisting Fuchs endothelial corneal dystrophy (FECD) and cataract. STUDY DESIGN Retrospective, interventional case series METHODS: We enrolled six eyes of three patients with coexisting FECD and cataract (3 women, age 67.8 ± 6.5 years) treated with presbyopia-correcting IOL implantation, followed by DMEK. The modified Krachmer grade, visual outcomes, and incidence of intra- and postoperative complications were analyzed. RESULTS Modified Krachmer FECD grades 4, 5, and 6 were observed in one, two, and three eyes, respectively. The mean best-corrected visual acuity (BCVA) was dissatisfactory with the primary presbyopia-correcting IOL (decimal 0.45), it improved significantly (decimal 1.0, P = 0.027) after DMEK and all eyes acquired satisfactory uncorrected distance and near (30 cm) vision (mean, decimal, distance 0.85 and near 0.56). The manifest spherical equivalent after DMEK was within the acceptable range (-0.375 D to 0.0 D). Rebubbling was required in four eyes, but no instances of other postoperative complications or primary graft failure were encountered. CONCLUSION DMEK staged after implantation of presbyopia-correcting IOLs is a viable option for patients with coexisting FECD and cataract.
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Affiliation(s)
- Hideaki Yokogawa
- Department of Ophthalmology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.
| | - Takahiko Hayashi
- Department of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Akira Kobayashi
- Department of Ophthalmology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan
| | - Natsuko Mori
- Department of Ophthalmology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan
| | | | | | - Masato Takeda
- Department of Ophthalmology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan
| | - Ami Igarashi
- Department of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Satoru Yamagami
- Department of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Itabashi, Tokyo, Japan
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Li L, Gao W, Deng F, Cao H, Zhen X, Wang Y. Changes in Corneal Densitometry Values of 50 Corneal Layers After Keratorefractive Lenticule Extraction (KLEx): A 6-Year Follow-Up. J Refract Surg 2025; 41:e365-e373. [PMID: 40197068 DOI: 10.3928/1081597x-20250305-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2025]
Abstract
PURPOSE To investigate the changes in the corneal densitometry (CD) values after keratorefractive lenticule extraction (KLEx) and their influencing factors. METHODS CD values of 50 layers of the right corneas of the participants, measured using a Pentacam (Oculus Optikgeräte GmbH) at different points after KLEx, were obtained from a database and analyzed. Repeated-measures analysis of variance was used to compare CDs between postoperative time, regions, and corneal depths. RESULTS Fifty-two participants were included. At 1 week after surgery, CDs of the corneal center, para-center, and non-incised periphery increased by 24.23%, 24.49%, and 11.42% at the superior and inferior 20 μm and 14.54%, 13.39%, and 7.82% at the superior and inferior 40 μm of the junctions of the corneal cap and stromal bed, respectively, from their preoperative values. No significant differences were observed in maximum CD values between the corneal center, para-center, and non-incised periphery groups between preoperative and 6-year postoperative measurements (P = .07, .81, and .96, respectively). CONCLUSIONS There was an initial significant increase in CD, particularly near the junctions of the corneal cap and stromal bed. Maximum CDs returned to preoperative values after 6 years. [J Refract Surg. 2025;41(4):e365-e373.].
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Yamada K, Oie Y, Nishida N, Maeno S, Kai C, Kitao M, Kobayashi R, Soma T, Koh S, Kawasaki R, Nishida K. Quality of Life Survey Using NEI VFQ-25 in Japanese Patients With Fuchs Endothelial Corneal Dystrophy. Eye Contact Lens 2025; 51:e135-e141. [PMID: 39661470 DOI: 10.1097/icl.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2024] [Indexed: 12/13/2024]
Abstract
OBJECTIVES To assess the quality of life in Japanese patients with Fuchs endothelial corneal dystrophy (FECD) using The National Eye Institute Visual Function Questionnaire. METHODS Here, 34 patients with FECD (FECD group) and 13 healthy individuals (control group) completed the National Eye Institute Visual Function Questionnaire Japanese version by interview format. The association between dominant eye corrected distance visual acuity and composite score (component 11) or subscales in the FECD group was evaluated using Spearman rank correlation coefficient. RESULTS The average age was 65.8±11.9 and 60.1±7.9 years in the FECD and control groups, respectively. Corrected distance visual acuity was significantly lower in the FECD group (0.021±0.21 logarithm of the minimum angle of resolution) than in the control group (-0.61±0.055 logarithm of the minimum angle of resolution) ( P <0.0001). Composite scores were significantly lower in the FECD group (77.6±11.0) than in the control group (89.2±7.0) ( P =0.0006). All subscale scores were lower in the FECD group, particularly for distance vision and mental health (81.4±13.1 and 84.0±15.6, respectively) than in the control group (90.7±12.0 and 95.7±5.7) ( P =0.022 and P =0.0046, respectively). Corrected distance visual acuity in the dominant eye did not significantly correlate with composite scores or subscales in the FECD group. CONCLUSIONS Quality of life is lower in patients with FECD than in healthy individuals, particularly regarding distance vision and mental health.
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Affiliation(s)
- Keiko Yamada
- Department of Ophthalmology (K.Y., Y.O., N.N., S.M., C.K., M.K., Reiko Kobayashi, T.S., S.K., K.N.), Osaka University Graduate School of Medicine, Suita, Osaka, Japan; and Division of Public Health (Ryo Kawasaki), Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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