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Clinical outcomes of central circular descemetorhexis and DMEK in patients with Fuchs�â�€�™ endothelial corneal dystrophy

Poster Details

First Author: E.Malyutina RUSSIA

Co Author(s):    B. Malyugin   O. Antonova                 

Abstract Details

Purpose:

The aim of this study is to evaluate the long-term clinical outcomes of patients who had circular descemetorhexis (CDR) without transplantation in comparison with DMEK patients with Fuchs�â�€�™ endothelial corneal dystrophy (FECD)

Setting:

S. Fyodorov Eye Microsurgery Federal Institution, Moscow, Russia

Methods:

First group included 20 eyes of 18 patients (13 women 5 man) with the mean age of 64,7�Â�± 9,9 years (range 51-84) having FECD and cataract, underwent US phacoemulsification, in-the-bag hydrophobic acrylic IOL implantation followed by CDR (4,0 mm in diameter) without endothelial transplantation. 12 patients reached 9 months of follow-up. The second group was 31 eyes of 31 patients (25 women, 6 man) with the mean age of 67,8�Â�±12,4 year, undergoing DMEK. Best-corrected visual acuity (BCVA), corneal pachymetry, endothelial cell density (ECD), was evaluated preoperatively, and 1, 7 days, and 1, 3, 6, 9 and 12 months postoperatively.

Results:

Following the surgery BCVA was 0,09�Â�±0,05 on the 1st day; 0,47�Â�±0,25 in 1; 0,59�Â�±0,31 in 3 ;0,65�Â�±0,31 in 6; 0,66�Â�±0,25 in 9 months. Corneal pachymetry were 585,17�Â�±51,57; 854,50�Â�±45,37; 656,67�Â�±106,54; 587,00�Â�±54,52; 614,63�Â�±90,91; 585,92�Â�±71,18; ECD in 9 months: 677,56�Â�±146,57 cells/mm2. DMEK group: BCVA was 0,1�Â�±0,05 and 0,5�Â�±0,12 in 7 days; 0,5�Â�±0,11 in 1;0,7�Â�±0,11 in 3; 0,7�Â�±0,19 in 9; 0,8�Â�±0,13 in 12; 0,8�Â�±0,11 in 24 months.Central corneal pachymetry were 588�Â�±12;552 �Â�± 49;564�Â�±22;541�Â�±18;551�Â�±38;573�Â�±41;The ECD was 1640�Â�±87 in 12 months.

Conclusions:

DR without endothelial replacement is successful in 65% of cases. CDR is a viable option for visual rehabilitation in selected patients with Fuchs�â�€�™ corneal endothelial dystrophy and cataract, eliminating the need for endothelial grafting. Further research is necessary to find out which category of patients will benefit best from that technology. The results of DMEK procedure demonstrated the possibility of achieving the final BCVA 3 months postoperatively which remains stable later on.

Financial Disclosure:

NONE

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