ESCRS - PP08.02 - Predictability Of Refractive Outcome Of Combined Descement Membrane Endothelial Keratoplasty And Cataract Surgery (Triple Dmek) In Eyes With Fuchs Endothelial Corneal Dystrophy (Fecd)

Predictability Of Refractive Outcome Of Combined Descement Membrane Endothelial Keratoplasty And Cataract Surgery (Triple Dmek) In Eyes With Fuchs Endothelial Corneal Dystrophy (Fecd)

Published 2022 - 40th Congress of the ESCRS

Reference: PP08.02 | Type: ESCRS 2022 - Posters | DOI: 10.82333/54nj-3v39

Authors: Julian Langer* 1 , Stefan Kassumeh 1 , Siegfried Priglinger 1 , Wolfgang J. Mayer 1

1Department of Ophthalmology,Ludwig-Maximilians-University, Munich, Germany,Munich,Germany

Purpose

Analysis of morphological and biometric variables to improve the predictability of refractive outcome after triple DMEK

Setting

A single-center retrospective study conducted at Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.

Methods

This retrospective study included 40 eyes of 26 patients who underwent combined descement membrane endothelial keratoplasty and cataract surgery (triple DMEK). Cause for the necessity of surgery was Fuchs endothelial corneal dystrophy (FECD) and cataract in all patients. Biometric and topographic corneal data was assessed using IOL-Master (Zeiss) and Pentacam (Oculus). IOL power calculation was performed with Haigis IOL formula. Prediction and absolute error were compared after 3 months based on manifest refraction and compared with Raytracing (Okulix). Furthermore, corneal morphological dataset was compared and analysed.

Results

All patients show an increase in visual acuity postoperatively. The absolut error (AE) of the Haigis IOL overall was 0.98 ± 0.87D and for Raytracing  1.11 ± 1.18D.  Postoperative overall spherical equivalent was -0.85D ± 4.64D after 3 month and -0.57D ± 3.75D after 6 months. Overall, pachymetric values showed no influence on refractive outcome. On the other hand corneal back configuration in Scheimpflug imaging seems to have an impact on refractive outcome in our cohort. The complete results of your ongoing study analyses will be presented at the congress.

Conclusions

The triple-DEMK procedure is well suited for patients with Fuchs endothelial corneal dystrophy and cataract. However, a higher risk of unexpected refractive outcome compared to a two-step procedure is a limiting factor. Therefore, there is a need for a better predictability of the refractive outcome. In our study, a closer examination of the corneal posterior surface configuration is shown to be a potentially suitable factor.