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Prospective comparative study: DMEK versus PhacoDMEK - results and survival at 6 months

Poster Details

First Author: M.Naveiras SPAIN

Co Author(s):    C. Lisa   B. Baamonde   J. Alfonso        

Abstract Details


To compare the results and survival of Descemet´s membrane endothelial keratoplasty (DMEK) versus a combined procedure of DMEK, phacoemulsification and intraocular lens (IOL) implantation (PhacoDMEK) in the management of Fuchs' endothelial dystrophy.


Instituto Oftalmológico Fernández-Vega. Oviedo. Spain.


Prospective, nonrandomized, clinical study at a tertiary referral center. The first group of 58 consecutive eyes treated for Fuchs´ were analysed according to the technique used: 56 patients were pseudophakic and treated with DMEK; 22 with concomitant endothelial disease shallow chamber and advanced cataract were treated with PhacoDMEK. Donors were prepared at the eyebank and stored in organ culture medium at 31º until implantation. Grafts were inserted with an ICL injector, encapsulated within viscoelastic plugs. Main Outcome Measures were: Primary and secondary success rate. Additional endpoints were best spectacle corrected visual acuity (BSCVA), endothelial cell density (ECD) and intra- and post- operative complications.


The procedure was initially successful in 69.4% of cases in DMEK and 79.4% in PhacoDMEK. Secondary re-interventions success rates were 83.3 and 86.4%. At 6 months BSCVA was 0.7 in DMEK and 0.8 in PhacoDMEK. Mean ECD loss was 44.1±12.2% in DMEK and 56.2±21% in PhacoDMEK. Absolute mean ECD were 1515.4±404.8 and 1217.2±641.2 cells/mm2. No significant differences were found.


Both DMEK alone and the combined triple procedure yield similar results in the management of Fuchs' endothelial dystrophy. Secondary re-interventions may be needed to resolve the case. The appropriate surgical approach will depend on the initial severity of the corneal edema and the presence of cataract. FINANCIAL INTEREST: NONE

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