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Performing DMEK with Other Surgical Procedures: Staged vs. Combined Approaches in Straightforward Cases

  • Cataract & Refractive Surgery (CE Starr and A Brissette, Section Editors)
  • Published:
Current Ophthalmology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Various strategies exist in the approach to patients requiring both cataract removal and endothelial keratoplasty. In this review, we seek to define the differences in keratoplasty technique relevant to a multi-procedure case; to discuss known outcomes of the triple procedure, as well as outcome differences compared to staged procedures; and to identify knowledge gaps in need of further investigation.

Recent findings

Optimal management of ocular comorbidities is becoming increasingly relevant with the rapid growth of Descemet membrane endothelial keratoplasty (DMEK) worldwide. The triple procedure combines endothelial keratoplasty, cataract extraction with lens implantation, and surgical iridotomy into a single surgical event. However, many approaches exist with regard to staged vs. combined procedures, and there are distinct advantages to each approach.

Summary

A surgeon’s experience and technical comfort will ultimately guide surgical planning. Deciding when to perform these procedures in a way most beneficial to the patient is essential to preoperative planning.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 11290-A PFP, Iowa City, IA, 52242, USA

    Yong W. Kam, David A. Ramirez, Jennifer J. Ling, Mark A. Greiner & Christopher S. Sales

  2. Iowa Lions Eye Bank, Coralville, IA, 52241, USA

    Mark A. Greiner & Christopher S. Sales

Authors
  1. Yong W. Kam
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  2. David A. Ramirez
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  3. Jennifer J. Ling
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  4. Mark A. Greiner
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  5. Christopher S. Sales
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Contributions

• Conceptualization: C.S.S., M.A.G., J.L.L.

• Literature search: Y.W.K., D.A.R., C.S.S.

• Writing—original draft preparation: Y.W.K., D.A.R., C.S.S.

• Writing—review and editing: Y.W.K., D.A.R., J.L.L., M.A.G., C.S.S.

Corresponding author

Correspondence to Christopher S. Sales.

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Conflict of Interest

Yong W. Kam, David A. Ramirez, Jennifer J. Ling, and Mark A. Greiner each declare no potential conflicts of interest. Christopher S. Sales receives royalties from Network Medical Coronet for intellectual property.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cataract & Refractive Surgery

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Kam, Y.W., Ramirez, D.A., Ling, J.J. et al. Performing DMEK with Other Surgical Procedures: Staged vs. Combined Approaches in Straightforward Cases. Curr Ophthalmol Rep 9, 57–64 (2021). https://doi.org/10.1007/s40135-021-00264-2

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  • DOI: https://doi.org/10.1007/s40135-021-00264-2

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