Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?

BACKGROUND:Clarity of the transplanted tissue and restoration of visual acuity are the two primary metrics for evaluating the success of corneal transplantation. Participation of the transplanted eye in habitual binocular viewing is seldom evaluated post-operatively. In unilateral corneal disease, t...

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Main Authors: Praveen K Bandela, PremNandhini Satgunam, Prashant Garg, Shrikant R Bharadwaj
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4777496?pdf=render
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author Praveen K Bandela
PremNandhini Satgunam
Prashant Garg
Shrikant R Bharadwaj
author_facet Praveen K Bandela
PremNandhini Satgunam
Prashant Garg
Shrikant R Bharadwaj
author_sort Praveen K Bandela
collection DOAJ
description BACKGROUND:Clarity of the transplanted tissue and restoration of visual acuity are the two primary metrics for evaluating the success of corneal transplantation. Participation of the transplanted eye in habitual binocular viewing is seldom evaluated post-operatively. In unilateral corneal disease, the transplanted eye may remain functionally inactive during binocular viewing due to its suboptimal visual acuity and poor image quality, vis-à-vis the healthy fellow eye. METHODS AND FINDINGS:This study prospectively quantified the contribution of the transplanted eye towards habitual binocular viewing in 25 cases with unilateral transplants [40 yrs (IQR: 32-42 yrs) and 25 age-matched controls [30 yrs (25-37 yrs)]. Binocular functions including visual field extent, high-contrast logMAR acuity, suppression threshold and stereoacuity were assessed using standard psychophysical paradigms. Optical quality of all eyes was determined from wavefront aberrometry measurements. Binocular visual field expanded by a median 21% (IQR: 18-29%) compared to the monocular field of cases and controls (p = 0.63). Binocular logMAR acuity [0.0 (0.0-0.0)] almost always followed the fellow eye's acuity [0.00 (0.00 --0.02)] (r = 0.82), independent of the transplanted eye's acuity [0.34 (0.2-0.5)] (r = 0.04). Suppression threshold and stereoacuity were poorer in cases [30.1% (13.5-44.3%); 620.8 arc sec (370.3-988.2 arc sec)] than in controls [79% (63.5-100%); 16.3 arc sec (10.6-25.5 arc sec)] (p<0.001). Higher-order wavefront aberrations of the transplanted eye [0.34 μ (0.21-0.51 μ)] were higher than the fellow eye [0.07 μ (0.05-0.11 μ)] (p<0.001) and their reduction with RGP contact lenses [0.09 μ (0.08-0.12 μ)] significantly improved the suppression threshold [65% (50-72%)] and stereoacuity [56.6 arc sec (47.7-181.6 arc sec)] (p<0.001). CONCLUSIONS:In unilateral corneal disease, the transplanted eye does participate in gross binocular viewing but offers limited support to fine levels of binocularity. Improvement in the transplanted eye's optics enhances its participation in binocular viewing. Current metrics of this treatment success can expand to include measures of binocularity to assess the functional benefit of the transplantation process in unilateral corneal disease.
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spelling doaj.art-0fe03fd9ba1c4718b2bb91d3948075b82022-12-21T19:50:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e015011810.1371/journal.pone.0150118Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?Praveen K BandelaPremNandhini SatgunamPrashant GargShrikant R BharadwajBACKGROUND:Clarity of the transplanted tissue and restoration of visual acuity are the two primary metrics for evaluating the success of corneal transplantation. Participation of the transplanted eye in habitual binocular viewing is seldom evaluated post-operatively. In unilateral corneal disease, the transplanted eye may remain functionally inactive during binocular viewing due to its suboptimal visual acuity and poor image quality, vis-à-vis the healthy fellow eye. METHODS AND FINDINGS:This study prospectively quantified the contribution of the transplanted eye towards habitual binocular viewing in 25 cases with unilateral transplants [40 yrs (IQR: 32-42 yrs) and 25 age-matched controls [30 yrs (25-37 yrs)]. Binocular functions including visual field extent, high-contrast logMAR acuity, suppression threshold and stereoacuity were assessed using standard psychophysical paradigms. Optical quality of all eyes was determined from wavefront aberrometry measurements. Binocular visual field expanded by a median 21% (IQR: 18-29%) compared to the monocular field of cases and controls (p = 0.63). Binocular logMAR acuity [0.0 (0.0-0.0)] almost always followed the fellow eye's acuity [0.00 (0.00 --0.02)] (r = 0.82), independent of the transplanted eye's acuity [0.34 (0.2-0.5)] (r = 0.04). Suppression threshold and stereoacuity were poorer in cases [30.1% (13.5-44.3%); 620.8 arc sec (370.3-988.2 arc sec)] than in controls [79% (63.5-100%); 16.3 arc sec (10.6-25.5 arc sec)] (p<0.001). Higher-order wavefront aberrations of the transplanted eye [0.34 μ (0.21-0.51 μ)] were higher than the fellow eye [0.07 μ (0.05-0.11 μ)] (p<0.001) and their reduction with RGP contact lenses [0.09 μ (0.08-0.12 μ)] significantly improved the suppression threshold [65% (50-72%)] and stereoacuity [56.6 arc sec (47.7-181.6 arc sec)] (p<0.001). CONCLUSIONS:In unilateral corneal disease, the transplanted eye does participate in gross binocular viewing but offers limited support to fine levels of binocularity. Improvement in the transplanted eye's optics enhances its participation in binocular viewing. Current metrics of this treatment success can expand to include measures of binocularity to assess the functional benefit of the transplantation process in unilateral corneal disease.http://europepmc.org/articles/PMC4777496?pdf=render
spellingShingle Praveen K Bandela
PremNandhini Satgunam
Prashant Garg
Shrikant R Bharadwaj
Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
PLoS ONE
title Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
title_full Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
title_fullStr Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
title_full_unstemmed Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
title_short Corneal Transplantation in Disease Affecting Only One Eye: Does It Make a Difference to Habitual Binocular Viewing?
title_sort corneal transplantation in disease affecting only one eye does it make a difference to habitual binocular viewing
url http://europepmc.org/articles/PMC4777496?pdf=render
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AT prashantgarg cornealtransplantationindiseaseaffectingonlyoneeyedoesitmakeadifferencetohabitualbinocularviewing
AT shrikantrbharadwaj cornealtransplantationindiseaseaffectingonlyoneeyedoesitmakeadifferencetohabitualbinocularviewing