Literature DB >> 25683875

DMEK in phakic eyes: targeted therapy or highway to cataract surgery?

Enken Gundlach1, Anna-Karina B Maier, Mikaella-Anthia Tsangaridou, Aline Isabel Riechardt, Tobias Brockmann, Eckart Bertelmann, Antonia M Joussen, Necip Torun.   

Abstract

PURPOSE: To investigate outcome and postoperative complications in patients undergoing isolated DMEK in phakic eyes compared to patients undergoing DMEK combined with cataract surgery (triple procedure).
METHODS: A retrospective analysis of 13 eyes undergoing DMEK in phakic eyes and 54 eyes undergoing triple procedure. Intraoperative and postoperative complications were recorded, visual acuity, refraction outcome, central corneal thickness, endothelial cell count and optical coherence tomography (OCT) of the anterior eye segment were evaluated 6 months postoperatively.
RESULTS: Graft detachment occurred in two eyes (18 %) undergoing phakic DMEK surgery and 23 eyes (50 %) undergoing triple procedure. Two eyes of the phakic group needed subsequent cataract surgery. In all cases, visual acuity significantly increased with a medium visual acuity of 0.13 ± 0.12 (phakic group, p = 0.005) and 0.15 ± 0.11 (triple group, p < 0.001) logMAR. Visual acuity of at least 0.1 logMAR was found in 55 % (phakic group) and 52 % (triple procedure group) of eyes. In the group after triple procedure, there were 62.8 % of eyes within 1 D of emmetropia. Corneal thickness was reduced to 515.3 ± 36.9 μm (phakic group, p = 0.012) and 516.5 ± 40.4 μm (triple group, p < 0.001). Endothelial cell count was reduced to 1529.7 ± 695.6/mm(2) (phakic group, p = 0.008) and 1,676.8 ± 355.2/mm(2) (triple group, p < 0.001).
CONCLUSIONS: DMEK in phakic eyes provides very good visual acuity with lower postoperative complications compared to eyes undergoing triple procedure. As the accommodative power can be preserved, this method is especially interesting for young patients.

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Year:  2015        PMID: 25683875     DOI: 10.1007/s00417-015-2956-8

Source DB:  PubMed          Journal:  Graefes Arch Clin Exp Ophthalmol        ISSN: 0721-832X            Impact factor:   3.117


  25 in total

1.  Posterior lamellar keratoplasty: DLEK to DSEK to DMEK.

Authors:  Gerrit R J Melles
Journal:  Cornea       Date:  2006-09       Impact factor: 2.651

2.  Cataract formation after penetrating keratoplasty.

Authors:  V M Rathi; M Krishnamachary; S Gupta
Journal:  J Cataract Refract Surg       Date:  1997-05       Impact factor: 3.351

Review 3.  [Result-related success rates of cataract operations. Results of a systematic literature review].

Authors:  U Hahn; F Krummenauer; I Neuhann
Journal:  Ophthalmologe       Date:  2012-06       Impact factor: 1.059

Review 4.  Evolution of endothelial keratoplasty.

Authors:  Francis W Price; Marianne O Price
Journal:  Cornea       Date:  2013-11       Impact factor: 2.651

5.  Refractive change and stability after Descemet membrane endothelial keratoplasty. Effect of corneal dehydration-induced hyperopic shift on intraocular lens power calculation.

Authors:  Lisanne Ham; Isabel Dapena; Kyros Moutsouris; Chandra Balachandran; Laurence E Frank; Korine van Dijk; Gerrit R J Melles
Journal:  J Cataract Refract Surg       Date:  2011-08       Impact factor: 3.351

6.  Endothelial cell loss after phacoemulsification in eyes with previous penetrating keratoplasty, previous deep anterior lamellar keratoplasty, or no previous surgery.

Authors:  Banu Torun Acar; Canan Asli Utine; Suphi Acar; Ferda Ciftci
Journal:  J Cataract Refract Surg       Date:  2011-09-16       Impact factor: 3.351

7.  Central cornea guttata. Incidence in the general population.

Authors:  D W Lorenzetti; M H Uotila; N Parikh; H E Kaufman
Journal:  Am J Ophthalmol       Date:  1967-12       Impact factor: 5.258

8.  Descemet membrane endothelial keratoplasty (DMEK).

Authors:  Gerrit R J Melles; T San Ong; Bob Ververs; Jacqueline van der Wees
Journal:  Cornea       Date:  2006-09       Impact factor: 2.651

9.  Intraoperative performance and longterm outcome of phacoemulsification in age-related cataract.

Authors:  Sheena A Dholakia; Abhay R Vasavada
Journal:  Indian J Ophthalmol       Date:  2004-12       Impact factor: 1.848

10.  Intraocular pressure elevation and post-DSEK glaucoma after Descemet`s stripping endothelial keratoplasty.

Authors:  Anna-Karina B Maier; Matthias K J Klamann; Necip Torun; Johannes Gonnermann; Jan Schroeter; Antonia M Joussen; Peter Rieck
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2012-11-20       Impact factor: 3.117

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  8 in total

Review 1.  [Triple Descemet membrane endothelial keratoplasty. Indications, variations and results].

Authors:  C Girbardt; P Wiedemann; A Nestler
Journal:  Ophthalmologe       Date:  2016-03       Impact factor: 1.059

2.  Using the posterior to anterior corneal curvature radii ratio to minimize the risk of a postoperative hyperopic shift after Descemet membrane endothelial keratoplasty.

Authors:  Raphael Diener; Nicole Eter; Maged Alnawaiseh
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2020-01-31       Impact factor: 3.117

3.  "Endothelium-Out" and "Endothelium-In" Descemet Membrane Endothelial Keratoplasty (DMEK) Graft Insertion Techniques: A Systematic Review With Meta-Analysis.

Authors:  Hon Shing Ong; Hla M Htoon; Marcus Ang; Jodhbir S Mehta
Journal:  Front Med (Lausanne)       Date:  2022-06-14

Review 4.  [Complications of Descemet's membrane endothelial keratoplasty].

Authors:  K Spaniol; M Borrelli; C Holtmann; S Schrader; G Geerling
Journal:  Ophthalmologe       Date:  2015-12       Impact factor: 1.059

5.  Intraocular lens power calculation using standard formulas and ray tracing after DMEK in patients with Fuchs endothelial dystrophy.

Authors:  Maged Alnawaiseh; Lars Zumhagen; André Rosentreter; Nicole Eter
Journal:  BMC Ophthalmol       Date:  2017-08-23       Impact factor: 2.209

Review 6.  Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty.

Authors:  Özlem Evren Kemer; Emine Esra Karaca; Silke Oellerich; Gerrit Melles
Journal:  Turk J Ophthalmol       Date:  2021-12-28

7.  Comparison of triple-DMEK to pseudophakic-DMEK: A cohort study of 95 eyes.

Authors:  Axelle Semler-Collery; Florian Bloch; George Hayek; Christophe Goetz; Jean Marc Perone
Journal:  PLoS One       Date:  2022-05-12       Impact factor: 3.240

8.  Effects of Combined Cataract Surgery on Outcomes of Descemet's Membrane Endothelial Keratoplasty: A Systematic Review and Meta-Analysis.

Authors:  Kai Yuan Tey; Sarah Yingli Tan; Darren S J Ting; Jodhbir S Mehta; Marcus Ang
Journal:  Front Med (Lausanne)       Date:  2022-03-29
  8 in total

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