Refractive Outcomes Following Combined Phacoemulsification And Descemet Membrane Endothelial Keratoplasty
Published 2026 - 44th Congress of the ESCRS
Reference: PP08.06 | Type: Free paper | DOI: 10.82333/4zf9-zk54
Authors: Dr Adele Mazzoleni* 1 , Daksh Raoul Kakkar 2 , Dr Vanessa Otti 3 , Dr Amal Minocha 3 , Dr Bita Manzouri 3
1Barking, Havering And Redbridge University Hospitals,London,United Kingdom, 2University College London,London,United Kingdom, 3Ophthalmology,Barking, Havering And Redbridge University Hospitals,London,United Kingdom
Purpose
The purpose of the audit was to evaluate refractive accuracy, visual outcomes and complications following combined phacoemulsification and DMEK.
Setting
A single-centre, retrospective audit was performed at a district general hospital ophthalmology department.
Methods
Data was collected across eyes undergoing phaco-DMEK between August 2020 and October 2025, inclusive of patient demographics, indication for surgery, biometry target refraction, postoperative refraction, best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), and postoperative complications. Refractive prediction error was calculated as the difference between postoperative spherical equivalent and intended target refraction. Missing data were not imputed.
Results
A total of thirty-three eyes were included with a mean patient age of 71.2 years. The indication was Fuchs endothelial corneal dystrophy for all cases. 51.5% of patients had other ocular comorbidities at the time of surgery. The mean preoperative BCVA was 0.38, improving to 0.15 postoperatively (p = p < 0.001). The mean target refraction was −0.43 D. In eyes with postoperative refraction available (n=10), the mean postoperative spherical equivalent was +0.03 D, corresponding to a mean hyperopic prediction error of +0.46 D.
There was no correlation between preoperative CCT and final BCVA (Spearman correlation ρ = 0.15-0.25; p = 0.3–0.5).
Rebubbling was required in 5 of 27 eyes (18.5%) with documented follow-up. Two failures were recorded.
Conclusions
Combined phaco-DMEK resulted in significant improvement in visual acuity with good overall refractive outcomes. A small hyperopic shift was observed postoperatively, suggesting that targeting slight myopia may help optimise refractive accuracy in these cases.