Anterior Segment Microvascular Metrics On Oct Angiography In Fuchs Endothelial Dystrophy: Impact Of Phaco-Dmek
Published 2026 - 44th Congress of the ESCRS
Reference: PP19.02 | Type: Free paper | DOI: 10.82333/re4g-rs85
Authors: Dr Emrullah Simsek* 1 , Dr Fahri Onur Aydin 1 , Dr Merve Tekinarslan 1 , Dr Yusuf Berk Akbas 1 , Dr Burcu Nurozler Tabakci 1 , A/Prof. Mehmet Ozgur Cubuk 1 , A/Prof. Burcin Kepez Yildiz 1
1Basaksehir Cam and Sakura City Hospital,Istanbul,Türkiye
Purpose
To compare anterior segment OCT angiography (AS-OCTA) vessel density among (1) eyes that underwent combined phacoemulsification + Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy, (2) the non-operated fellow eyes of Fuchs patients, and (3) age-matched healthy controls.
Setting
Basaksehir Cam and Sakura City Hospital
Methods
This cross-sectional study included 73 eyes of 55 participants: 24 operated Fuchs eyes 15 unoperated fellow Fuchs eyes and 34 control eyes. AS-OCTA vessel density was recorded in four quadrants (superonasal, superotemporal, inferonasal, inferotemporal) and as the global mean (OCTA mean). Group comparisons were performed using Gaussian generalized estimating equations (GEE) with an exchangeable working correlation structure (clustered by participant) and adjusted for age and sex.
Results
Mean age was similar across groups (61.8±10.2, 61.3±10.4, and 64.7±10.4 years for operated, fellow, and controls; p=0.286), while sex distribution differed (female 70.8%, 60.0%, and 32.4%; p=0.011). OCTA mean was 43.5±8.9 (operated), 42.5±8.7 (fellow), and 40.7±5.2 (controls). In adjusted GEE analysis, overall group differences were significant (p=0.043); operated eyes had higher OCTA mean than controls (p=0.031),while operated and fellow eyes were similar (p=0.557). For quadrants, group differences were observed in the superotemporal (41.1±9.6 vs 36.6±5.3 for operated vs controls; p=0.008) and superonasal regions (39.1±9.9 vs 35.5±6.5 for operated vs controls; p=0.034),whereas inferonasal and inferotemporal values were comparable (p>0.05).
Conclusions
AS-OCTA vessel density showed modest between-group differences, with operated Fuchs eyes demonstrating higher global mean and higher superior-quadrant metrics compared with healthy controls, while operated and fellow Fuchs eyes did not significantly differ. Longitudinal studies are needed to clarify whether these changes reflect postoperative vascular remodeling or other perioperative factors.