Comparison Of Pre- And Post-Dmek Keratometry And Total Keratometry Values For Iol Power Calculations In Eyes Undergoing Triple Dmek
Published 2023 - 41st Congress of the ESCRS
Reference: PP08.01 | Type: Free paper | DOI: 10.82333/qc6n-7s75
Authors: Jascha Wendelstein* 1 , Katrin Wacker 2 , David Cooke 3 , Thomas Reinhard 2 , Neal Rangu 4 , Kamran Riaz 4
1IROC,Zürich,Switzerland;Kepler University hospital,Linz,Austria;Saarland University,Saarland,Germany, 2University Clinic Freiburg,Freiburg,Germany, 3Great Lake Eye Care,St. Joseph,United States, 4Dean A. McGee Eye Institute / University of Oklahoma,Oklahoma City,United States
Purpose
To evaluate the prediction accuracy of pre- and post-DMEK keratometry (K) and total keratometry (TK) values for IOL power calculations for eyes undergoing DMEK with cataract surgery (triple DMEK).
Setting
Two academic centers in the USA and Europe. (Dean McGee eye Institute - Oklahoma City University, United States; University Hospital Freiburg, Germany)
Methods
Retrospective cross-sectional multicenter study.
Study Population: Review of 55 eyes that underwent triple DMEK between 2019 and 2022. Pre- and post-DMEK biometry measurements were obtained with an optical biometer (IOLMaster 700). K and TK values were used for IOL power calculations with ten formulae (Barrett Universal II (BU2), Castrop, EVO 2.0, Hoffer QST, K6, Kane, Haigis, Holladay 1, SRK/T, and Hoffer Q)
Main Outcome Measures: Mean error, mean absolute error (MAE), standard deviation, and percentage of eyes within prediction errors of ±0.50 diopters (D) and ±1.00 D were calculated. Formulae were also internally adjusted by the prediction for an IOL power 1D below the IOL used (IOLup1D).
Results
MAEs for all formulae were lower for post-DMEK K and TK than pre-DMEK K and TK by an average of 0.24 and 0.47 D, respectively. The lowest MAE value was 0.49 D for Kane using post-DMEK TK, and the highest MAE value observed was 1.05 D for BU2 using pre-DMEK TK respectively. Most IOLup1D adjusted-formulae had lower MAEs than formulae using pre-DMEK K and TK.
Conclusions
When performing triple DMEK, the IOLup1D method should be used instead of pre-DMEK K and TK values. If feasible, surgeons may perform cataract surgery after DMEK and utilize post-DMEK TK values for improved accuracy.