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Five-year follow-up of corneal morphology and corneal refractive power changes after uneventful DMEK

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Abstract

Purpose

To investigate changes of corneal thickness spatial profile (CTSP), corneal volume (CV) distribution, and total corneal refractive power (TCRP) over a course of 60 months after uneventful Descemet membrane endothelial keratoplasty (DMEK).

Methods

In our prospective, comparative study, sixty DMEK cases without intraoperative and postoperative complications and with complete 60-month follow-up were included (group 1). CTSP at corneal apex (CCT) and at 2 mm, 4 mm, 6 mm, and 8 mm rings, CV in 3 mm, 5 mm, 7 mm, and 10 mm zones, and TCRF in 2 mm, 4 mm 6 mm, and 8 mm zones were evaluated preoperatively and at 3, 6, 12, 24, and 60 months postoperatively. The 60-month results were compared to an age-matched group of uncomplicated pseudophakic eyes (group 2; n = 20).

Results

The CCT and CTSP at 2, 4, and 6 mm increased significantly at 60 months compared to 3-month outcomes (P < 0.001). Similarly, CV increased significantly in 3 mm, 5 mm, and 7 mm zones at 60 months compared to 3 months outcomes (P < 0.001). The TCRP showed in all zones a significant decrease at 3 months (P < 0.001) followed by a continuous and significant increase at 60 months (P < 0.001). The 60-month CCT and CTSP at 2 mm were similar to group 2 (P ≥ 0.094).

Conclusion

Sixty months after uneventful DMEK, CT within the central 2 mm zone and CV at 3 mm zone were similar to uncomplicated pseudophakic eyes. A continuous and statistically significant increase of TCRP was observed in all measured zones after the 3-month examination. 

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References

  1. Droutsas K, Giallouros E, Melles GR, Chatzistefanou K, Sekundo W (2013) Descemet membrane endothelial keratoplasty: learning curve of a single surgeon. Cornea 32:1075–1079. https://doi.org/10.1097/ICO.0b013e31828f0e3c

    Article  PubMed  Google Scholar 

  2. Peraza-Nieves J, Baydoun L, Dapena I, Ilyas A, Frank LE, Luceri S, Ham L, Oellerich S, Melles GRJ (2017) Two-year clinical outcome of 500 consecutive cases undergoing Descemet membrane endothelial keratoplasty. Cornea 36:655–660. https://doi.org/10.1097/ICO.0000000000001176

    Article  PubMed  Google Scholar 

  3. Goldich Y, Showail M, Avni-Zauberman N, Perez M, Ulate R, Elbaz U, Rootman DS (2015) Contralateral eye comparison of descemet membrane endothelial keratoplasty and descemet stripping automated endothelial keratoplasty. Am J Ophthalmol 159:155–159. https://doi.org/10.1016/j.ajo.2014.10.009

    Article  PubMed  Google Scholar 

  4. Droutsas K, Lazaridis A, Papaconstantinou D, Brouzas D, Moschos MM, Schulze S, Sekundo W (2016) Visual outcomes after Descemet membrane endothelial keratoplasty versus Descemet stripping automated endothelial keratoplasty-comparison of specific matched pairs. Cornea 35:765–771. https://doi.org/10.1097/ICO.0000000000000822

    Article  PubMed  Google Scholar 

  5. Singh A, Zarei-Ghanavati M, Avadhanam V, Liu C (2017) Systematic review and meta-analysis of clinical outcomes of Descemet membrane endothelial keratoplasty versus Descemet stripping endothelial keratoplasty/Descemet stripping automated endothelial keratoplasty. Cornea 36:1437–1443. https://doi.org/10.1097/ICO.0000000000001320

    Article  PubMed  Google Scholar 

  6. Zhu L, Zha Y, Cai J, Zhang Y (2018) Descemet stripping automated endothelial keratoplasty versus descemet membrane endothelial keratoplasty: a meta-analysis. Int Ophthalmol 38:897–905. https://doi.org/10.1007/s10792-017-0533-3

    Article  PubMed  Google Scholar 

  7. Li S, Liu L, Wang W, Huang T, Zhong X, Yuan J, Liang L (2017) Efficacy and safety of Descemet’s membrane endothelial keratoplasty versus Descemet’s stripping endothelial keratoplasty: a systematic review and meta-analysis. PLoS ONE 12:e0182275. https://doi.org/10.1371/journal.pone.0182275

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Tourtas T, Laaser K, Bachmann BO, Cursiefen C, Kruse FE (2012) Descemet membrane endothelial keratoplasty versus descemet stripping automated endothelial keratoplasty. Am J Ophthalmol 153:1082–1090. https://doi.org/10.1016/j.ajo.2011.12.012

    Article  PubMed  Google Scholar 

  9. Hos D, Tuac O, Schaub F, Stanzel TP, Schrittenlocher S, Hellmich M, Bachmann BO, Cursiefen C (2017) Incidence and clinical course of immune reactions after Descemet membrane endothelial keratoplasty: retrospective analysis of 1000 consecutive eyes. Ophthalmology 124:512–518. https://doi.org/10.1016/j.ophtha.2016.12.017

    Article  PubMed  Google Scholar 

  10. Turnbull AM, Tsatsos M, Hossain PN, Anderson DF (2016) Determinants of visual quality after endothelial keratoplasty. Surv Ophthalmol 61:257–271. https://doi.org/10.1016/j.survophthal.2015.12.006

    Article  PubMed  Google Scholar 

  11. Rudolph M, Laaser K, Bachmann BO, Cursiefen C, Epstein D, Kruse FE (2012) Corneal higher-order aberrations after Descemet’s membrane endothelial keratoplasty. Ophthalmology 119:528–535. https://doi.org/10.1016/j.ophtha.2011.08.034

    Article  PubMed  Google Scholar 

  12. Goldich Y, Artornsombidth P, Avni-Zauberman N, Perez M, Ulate R, Elbaz U, Rootman DS (2014) Fellow eye comparison of corneal thickness and curvature in descemet membrane endothelial keratoplasty and descemet stripping automated endothelial keratoplasty. Cornea 33:547–550. https://doi.org/10.1097/ICO.0000000000000118

    Article  PubMed  Google Scholar 

  13. Ham L, Dapena I, Moutsouris K, Balachandran C, Frank LE, van Dijk K, Melles GR (2011) Refractive change and stability after Descemet membrane endothelial keratoplasty. Effect of corneal dehydration-induced hyperopic shift on intraocular lens power calculation. J Cataract Refract Surg 37:1455–1464. https://doi.org/10.1016/j.jcrs.2011.02.033

    Article  PubMed  Google Scholar 

  14. Cheung AY, Chachare DY, Eslani M, Schneider J, Nordlund ML (2018) Tomographic changes in eyes with hyperopic shift after triple Descemet membrane endothelial keratoplasty. J Cataract Refract Surg 44:738–744. https://doi.org/10.1016/j.jcrs.2018.04.040

    Article  PubMed  Google Scholar 

  15. Droutsas K, Lazaridis A, Giallouros E, Kymionis G, Chatzistefanou K, Sekundo W (2018) Scheimpflug densitometry after DMEK versus DSAEK-two-year outcomes. Cornea 37:455–461. https://doi.org/10.1097/ICO.0000000000001483

    Article  PubMed  Google Scholar 

  16. Lazaridis A, Giallouros E, Sekundo W, Schroeder FM, Sklavos S, Droutsas K (2019) Spatial analysis of corneal densitometry, thickness profile, and volume distribution after uneventful Descemet membrane endothelial keratoplasty. Cornea 38:1215–1221. https://doi.org/10.1097/ICO.0000000000002035

    Article  PubMed  Google Scholar 

  17. Lazaridis A, Fydanaki O, Giallouros E, Georgalas I, Kymionis G, Sekundo W, Droutsas K (2018) Recovery of corneal clarity after DMEK followed by rebubbling versus uneventful DMEK. Cornea 37:840–847. https://doi.org/10.1097/ICO.0000000000001554

    Article  PubMed  Google Scholar 

  18. Kwon RO, Price MO, Price FW Jr, Ambrósio R Jr, Belin MW (2010) Pentacam characterization of corneas with Fuchs dystrophy treated with Descemet membrane endothelial keratoplasty. J Refract Surg 26:972–979. https://doi.org/10.3928/1081597X-20100212-08

    Article  PubMed  Google Scholar 

  19. Ham L, Dapena I, Liarakos VS, Baydoun L, van Dijk K, Ilyas A, Oellerich S, Melles GR (2016) Midterm results of Descemet membrane endothelial keratoplasty: 4 to 7 years clinical outcome. Am J Ophthalmol 171:113–121. https://doi.org/10.1016/j.ajo.2016.08.038

    Article  PubMed  Google Scholar 

  20. Schlögl A, Tourtas T, Kruse FE, Weller JM (2016) Long-term clinical outcome after Descemet membrane endothelial keratoplasty. Am J Ophthalmol 169:218–226. https://doi.org/10.1016/j.ajo.2016.07.002

    Article  PubMed  Google Scholar 

  21. Ambrósio R Jr, Alonso RS, Luz A, Coca Velarde LG (2006) Corneal-thickness spatial profile and corneal-volume distribution: tomographic indices to detect keratoconus. J Cataract Refract Surg 32:1851–1859. https://doi.org/10.1016/j.jcrs.2006.06.025

    Article  PubMed  Google Scholar 

  22. Lie JT, Birbal R, Ham L, van der Wees J, Melles GR (2008) Donor tissue preparation for Descemet membrane endothelial keratoplasty. J Cataract Refract Surg 34:1578–1583. https://doi.org/10.1016/j.jcrs.2008.05.036

    Article  PubMed  Google Scholar 

  23. Droutsas K, Kappos N, Giallouros E, Schroeder FM, Sekundo W, Kandarakis S, Lazaridis A (2021) Corneal densitometry after uneventful Descemet membrane endothelial keratoplasty-5-year outcomes. Cornea. Advance online publication. https://doi.org/10.1097/ICO.0000000000002919

  24. Alnawaiseh M, Rosentreter A, Eter N, Zumhagen L (2016) Changes in corneal refractive power for patients with Fuchs endothelial dystrophy after DMEK. Cornea 35:1073–1077. https://doi.org/10.1097/ICO.0000000000000842

    Article  PubMed  Google Scholar 

  25. Alnawaiseh M, Zumhagen L, Rosentreter A, Eter N (2017) Changes in anterior, posterior, and total corneal astigmatism after Descemet membrane endothelial keratoplasty. J Ophthalmol 2017:4068963. https://doi.org/10.1155/2017/4068963

    Article  PubMed  PubMed Central  Google Scholar 

  26. Fityo S, Bühren J, Shajari M, Kohnen T (2016) Keratometry versus total corneal refractive power: analysis of measurement repeatability with 5 different devices in normal eyes with low astigmatism. J Cataract Refract Surg 42:569–576. https://doi.org/10.1016/j.jcrs.2015.11.046

    Article  PubMed  Google Scholar 

  27. Qian Y, Liu Y, Zhou X, Naidu RK (2017) Comparison of corneal power and astigmatism between simulated keratometry, true net power, and total corneal refractive power before and after SMILE surgery. J Ophthalmol 2017:9659481. https://doi.org/10.1155/2017/9659481

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tonn B, Klaproth OK, Kohnen T (2014) Anterior surface-based keratometry compared with Scheimpflug tomography-based total corneal astigmatism. Invest Ophthalmol Vis Sci 56:291–298. https://doi.org/10.1167/iovs.14-15659

    Article  PubMed  Google Scholar 

  29. Diener R, Treder M, Lauermann JL, Eter N, Alnawaiseh M (2021) Assessing the validity of corneal power estimation using conventional keratometry for intraocular lens power calculation in eyes with Fuch’s dystrophy undergoing Descemet membrane endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol 259:1061–1070. https://doi.org/10.1007/s00417-020-04998-w

    Article  CAS  PubMed  Google Scholar 

  30. Weikert MP, Golla A, Wang L (2018) Astigmatism induced by intraocular lens tilt evaluated via ray tracing. J Cataract Refract Surg 44:745–749. https://doi.org/10.1016/j.jcrs.2018.04.035

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Philipps University of Marburg, 35043, BaldingerstraßeMarburg, Germany

    Apostolos Lazaridis, Bogdan Spiru, Elefterios Giallouros, Walter Sekundo, Frank Michael Schroeder, Anke Messerschmidt-Roth & Konstantinos Droutsas

  2. First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece

    Konstantinos Droutsas

Authors
  1. Apostolos Lazaridis
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  2. Bogdan Spiru
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  3. Elefterios Giallouros
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  4. Walter Sekundo
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  5. Frank Michael Schroeder
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  6. Anke Messerschmidt-Roth
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  7. Konstantinos Droutsas
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Corresponding author

Correspondence to Apostolos Lazaridis.

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Ethical approval.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (University Eye Clinic of Marburg) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.

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The authors declare no competing interests.

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Informed consent was obtained from all individual participants included in the study.

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Lazaridis, A., Spiru, B., Giallouros, E. et al. Five-year follow-up of corneal morphology and corneal refractive power changes after uneventful DMEK. Graefes Arch Clin Exp Ophthalmol 260, 2309–2319 (2022). https://doi.org/10.1007/s00417-022-05571-3

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  • DOI: https://doi.org/10.1007/s00417-022-05571-3

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