Descemet’S Membrane Endothelial Keratoplasty And Phacoemulsification: Combined Versus Sequential Surgery
Published 2025 - 43rd Congress of the ESCRS
Reference: FP31.01 | Type: Free paper | DOI: 10.82333/9kds-c257
Authors: Claudette Abela-Formanek* 1 , Gerd Auffarth 2 , Allon Barsam 3 , Basak Bostanci 4 , Francesco Carones 5 , Dean Corbett 6 , Tiago Ferreira 7 , Fernando Llovet 8 , Sanjay Mantry 9 , Alain Saad 10
1Medical University of Vienna,Department of Ophthalmology,Vienna,Austria, 2University of Heidelberg,Department of Ophthalmology,Heidelberg,Germany, 3OCL Vision,London,United Kingdom, 4Bahçeşehir Üniversitesi Tıp Fakültesi,Suadiye Dünya Göz Hastanesi,Istanbul,Türkiye, 5ADVALIA Vision,Milan,Italy, 6Auckland Eye,Aukland,New Zealand, 7Clínica Privada de Oftalmologia,Lisbon ,Portugal, 8Clinica Baviera Aier Group,Valencia,Spain, 9Vision Scotland,Edinburgh,United Kingdom, 10Rothschild Foundation Hospital,Paris,France
Purpose
To compare the outcomes of Descemet’s membrane endothelial keratoplasty (DMEK) combined with
phacoemulsification versus DMEK following phacoemulsification.
Setting
Institutional tertiary referral center university hospital
Methods
In this interventional retrospective comparative nonrandomized case series study, patients with Fuchs
endothelial corneal dystrophy (FECD) with either cataract or previous cataract surgery with intraocular
lens (IOL) implantation were assigned to one of the two groups according to lens status. Group 1
included patients who had cataract and FECD and would undergo triple procedure (phacoemulsification
with IOL implantation and DMEK), whereas Group 2 included patients who had FECD and had
phacoemulsification with IOL implantation earlier and would undergo DMEK only as a sequential
procedure.
Results
Postoperative BCVA in both groups at 1 month, 3 months, and 6 months revealed a statistically
nonsignificant difference with mean logMAR BCVA at 6 months of 0.07 ± 0.18 and 0.07 ± 0.19 in Group 1
and Group 2, respectively (P > 0.05). The drop in endothelial cell density by the end of the 6th
postoperative month was by 39.44% ±7.92 and 38.73% ±8.10 in the triple‑procedure group and DMEK
only group, respectively (P = 0.005). The total postoperative complications rate and the rebubbling rate
were statistically similar between both groups (P > 0.05).
Conclusions
Visual outcomes, endothelial cell loss, and rebubbling rate are comparable when DMEK is combined with
phacoemulsification or when it is performed as staged procedure, without statistically significant
difference in the outcomes.