Refractive And Corneal Property Changes After Dmek Endothelial Corneal Transplantation

The aim of this study is to evaluate corneal changes using Pentacam HR® tomography one year after combined cataract surgery and endothelial keratoplasty DMEK (Triple procedure).

Hospital Clinico San Carlos, Madrid Spain. Cornea department.

This is a longitudinal, retrospective, and observational study including 25 eyes from 25 subjects with corneal decompensation due to Fuchs' endothelial dystrophy and cataract, who underwent phaco-DMEK. Examination performed included corneal tomography with Pentacam HR® one month before and one year after surgery. Corneal parameters such as thickness, Km, Kmax, asphericity (Qp), corneal densitometry were analyzed. Statistical analysis using SPSS with a significance level of p=0.05%.

The mean age of the subjects was 65.25 ± 6.74 years, with 66% being women. A significant postoperative reduction was observed one year after surgery in corneal thickness (662.50 ± 56.77 µm vs. 524.44 ± 33.61 µm; p < 0.001), Km (44.35 ± 1.82 D vs. 43.61 ± 1.23 D; p = 0.006), Kmax (45.01 ± 1.91 D vs. 44.11 ± 1.67 D; p = 0.003), corneal volume (63.75 ± 4.82 vs. 59.84 ± 3.44; p = 0.006), Qp (0.27 to -0.23; p = 0.013), and corneal densitometry in the 2 to 12 mm rings (p < 0.05).

Triple procedure proves to be an effective and safe technique for the simultaneous management of corneal endothelial dysfunction and cataract. Studies indicate that it reduces corneal curvature and thickness, potentially leading to a final hyperopic refractive outcome of -0.5 to 1 D. Additionally, corneal density significantly decreased, particularly in the paracentral and peripheral rings.