Title: Quantitative And Qualitative Refractive Outcomes Of Combined Phaco- Dmek Surgery In Fuchs Endothelial Dystrophy

This study aimed to evaluate refractive outcomes and variations in higher-order aberrations (HOAs) following combined phacoemulsification and Descemet membrane endothelial keratoplasty (phaco-DMEK) in patients with Fuchs endothelial dystrophy (FECD). The focus was on patients suffering from decreased visual acuity and diurnal fluctuations attributable to varying degrees of corneal dysfunction.

Clinical Emergency Eye Hospital Bucharest

 A cohort of FECD patients with diverse levels of corneal dysfunction underwent combined phaco-DMEK surgery with single-piece intraocular lens implantation. Preoperative evaluations included slit-lamp examinations, biometry, anterior segment optical coherence tomography (AS-OCT) to quantify corneal edema, and analysis of HOAs. The refractive target was individualized according to the severity of corneal edema. Postoperative assessments were conducted at 1, 3, and 6 months, evaluating best-corrected visual acuity (BCVA), refractive status, and corneal topography.

We present the refractive outcomes in eyes who underwent phaco-DMEK surgery. The patients have been evaluated preoperatively, 1 month, 3 months and 6 months post operatively. The degree of improvement in visual quality has been monitored using evaluation of best corrected visual acuity (BCVA), refractive analysis and tomographic maps. 

For most patients, refractive stability was achieved after three months post-operatively. BCVA improved, however not all patients gained spectacle independence, but the decrease in HOA significantly improved their overall satisfaction, enabling them to return to an active lifestyle.