Enhanced Monofocal Iols In Combined Dmek And Cataract Surgery

To compare visual outcomes and higher-order aberrations (HOA) of an enhanced monofocal aspheric IOL compared to a monofocal aspheric IOL in patients after DMEK combined with cataract surgery.

Descemet membrane endothelial keratoplasty (DMEK) is the current gold standard surgical procedure to treat Fuchs Endothelial Corneal Dystrophy (FECD). Cataract surgery with intraocular lens (IOL) can be safely combined with corneal procedure. We present our case series, comparing phaco-DMEK with standard monofocal IOLs versus enhanced monofocal IOLs.

We analyzed forty eyes from forty patients, divided in two groups. Twenty eyes operated with phaco-DMEK and monofocal IOLs versus twenty with phaco-DMEK and enhanced IOLs. We evaluated the visual results six months after the operation. Six months post operatively uncorrected distance(UDVA) at 4m; intermediate (UIVA) at 66 cm, and near visual acuity (UNVA) at 44 cm, as well as best-corrected distance (BCVA), intermediate (BCIVA) and near visual acuity (BCNVA) ; monocular defocus curve were measured. Contrast sensivity under photopic and mesopic conditions, higher-order aberrations (HOAs) at pupil size 4 mm, objective scatter index (OSI), Strehl ratio, modulation transfer function (MTF) halo and glare perception, were also evaluated.

The two groups did not present statistically significant differences in terms of BCVA at distance, defocus curve, photopic contrast sensivity, higher-order aberrations (HOA), OSI, Strehl ratio and MTF. The mean rebubbling rate was 0.4±0.7 per eye in both groups. In phaco DMEK enhanced monofocal IOL group a significance better results in uncorrected monocular intermediate visual acuity and corrected monocular intermediate visual acuity than standard monofocal IOL group were noted.

Enhanced monofocal IOLs represent a good option for patient with Fuchs desease undergoing cataract surgery.