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

  • Cornea
  • Published:
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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/mm2 (phakic group, p = 0.008) and 1,676.8 ± 355.2/mm2 (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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Acknowledgments

Enken Gundlach: Financial support provided by the “Ernst und Bertha Grimmke Stiftung”, Germany

Anna-Karina B. Maier: Financial support provided by the “Friedrich C. Luft” Clinical Scientist Pilot Program funded by Volkswagen Foundation and Charité Foundation

Competing interest

All authors, none declared.

The authors have full control of all primary data and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review data upon request.

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    Authors and Affiliations

    1. Klinik für Augenheilkunde, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Mittelallee 4, Augustenburgerplatz 1, 13353, Berlin, Germany

      Enken Gundlach, Anna-Karina B. Maier, Mikaella-Anthia Tsangaridou, Aline Isabel Riechardt & Necip Torun

    2. Klinik für Augenheilkunde, Charité Universitätsmedizin, Campus Virchow Klinikum, Mittelallee 4, Augustenburgerplatz 1, 13353, Berlin, Germany

      Tobias Brockmann, Eckart Bertelmann & Antonia M. Joussen

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    1. Enken Gundlach
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    Correspondence to Enken Gundlach.

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    Enken Gundlach and Anna-Karina B. Maier contributed equally to this work.

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    Gundlach, E., Maier, AK.B., Tsangaridou, MA. et al. DMEK in phakic eyes: targeted therapy or highway to cataract surgery?. Graefes Arch Clin Exp Ophthalmol 253, 909–914 (2015). https://doi.org/10.1007/s00417-015-2956-8

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    • DOI: https://doi.org/10.1007/s00417-015-2956-8

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