In this issue of JAMA Ophthalmology, Ang et al1 describe a prespecified secondary outcome of the Descemet Endothelial Thickness Comparison Trial (DETECT), a study designed to compare visual acuity outcomes from ultrathin Descemet stripping endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). The main and primary study outcome was that DMEK eyes saw 1.4 lines better than UT-DSAEK eyes at 12 months. Although visual acuity is the traditional functional measure of surgical success in ophthalmology, increasingly patient-reported outcomes, particularly those measuring vision-related quality of life (QOL), are used to confirm and ensure the utility of the results to patients. With the high anatomical success rate of current corneal transplant techniques, graft clarity in Fuchs dystrophy, the population studied here, is essentially presumed. In DETECT, the QOL improvements were clinically and statistically significant in both groups (9.6-12.6 points on a 100-point scale), without a statistically significant difference between groups.
Sugar A. Quality of Life After Endothelial Keratoplasty. JAMA Ophthalmol. Published online May 02, 2019137(7):754–755. doi:10.1001/jamaophthalmol.2019.0940
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