ESCRS - FP10.09 - Phakic Descemet Membrane Endothelial Keratoplasty (Dmek): Influence On Intraocular Lens Power Calculation.

Phakic Descemet Membrane Endothelial Keratoplasty (Dmek): Influence On Intraocular Lens Power Calculation.

Published 2023 - 41st Congress of the ESCRS

Reference: FP10.09 | Type: Free paper | DOI: 10.82333/bk7r-hg64

Authors: Raphael Diener* 1 , Martin Dominik Leclaire 1 , Nicole Eter 1 , Lamis Baydoun 2

1Department of Ophthalmology,University of Muenster Medical Center,Muenster,Germany, 2Department of Ophthalmology,University of Muenster Medical Center,Muenster,Germany;ELZA Institute,Dietikon/Zurich,Switzerland

Purpose

To compare intraocular lens (IOL) power calculation in eyes with Fuchs endothelial corneal dystrophy (FECD) before and after phakic Descemet membrane endothelial keratoplasty (DMEK). 

Setting

University of Muenster Medical Center, Department of Ophthalmology

Methods

Retrospective analysis of 21 phakic eyes of 18 patients (13 female, 5 male) with FECD, with an average age of 58±6 years. All patients underwent IOL power calculation (IOL Master 500 or 700) before and at a minimum of 3 months after uncomplicated phakic DMEK. Postoperative change of parameters relevant for IOL power calculation including the anterior chamber depth (ACD), both flat and steep keratometry values (K1, K2) and axial length (AL) were analyzed. In addition, the influence of the parameters on IOL power calculation using Haigis and SRK/T formulas was determined.

Results

Postoperatively, the flat keratometry values decreased significantly (-0.34 ± 0.59 Diopters (Dpt) (P<0.02), whereas the steep keratometry values (∆-0.09 ± 0.71 Dpt.; P>0.05), ACD (∆0.05±0.24mm; P>0.05) and AL (∆-0.01±0.03mm; P>0.05) did not change. The predicted refraction changed significantly for the same IOL (Zeiss CT Lucia 211P) with an average power of 22.95 ± 2.73 Dpt. from -0.54 ± 0.83 to -0.07 ± 0.95 (P<0.01) and from -0.46 ± 0.82 to -0.04 ± 0.99 (P<0.01) using the Haigis and SRK/T formula, respectively.

Conclusions

Phakic DMEK significantly influences IOL power calculation. The impact of these changes on the prediction error after cataract surgery in eyes with previous phakic DMEK needs further investigation.