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Descemet's membrane endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation (Triple-DMEK) in eyes with cataract and Fuchs endothelial dystrophy

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Session Details

Session Title: Modarated Poster Session: Hot and New

Session Date/Time: Monday 07/09/2015 | 14:00-15:00

Paper Time: 14:40

Venue: Poster Village: Pod 1

First Author: : K.Droutsas GREECE

Co Author(s): :    S. Souki   A. Lazaridis   A. Mouchtouris   D. Miltsakakis   D. Papaconstantinou   C. Koutsandrea

Abstract Details


Purpose of the study was to evaluate the anatomic and functional outcome of Descemet Membrane Endothelial Keratoplasty (DMEK) combined with phacoemulsification and intraocular lens implantation in patients with Fuchs Endothelial Dystrophy (FED) and cataract.


First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece.


Six eyes of 5 patients with FED and cataract underwent Triple-DMEK. For the preparation of the DMEK graft a corneoscleral button stored in Optisol-GS at 4C was used. Preparation was performed immediately before the procedure using the techniques of the Netherlands Institute for Innovative Ocular Surgery (NIIOS). After successful preparation, phacoemulsification and DMEK were performed under subtenon's anesthesia. The NIIOS standardized no-touch technique was applied for DMEK surgery. Postoperative examinations were performed at one, three, 6 and 12 months. Main outcome measures included best-corrected visual acuity (BCVA), endothelial cell density (ECD) and complications e.g. graft detachment, failure, or rejection.


Triple-DMEK was successful in all cases. A posterior chamber intraocular lens was implanted in all cases. Mean BCVA ranged from hand movement to 0.3 before, and from 0.7 to 1.0 at 6 months after the procedure. The main ECD dropped from 2716 ± 239 cells/mm2 (donor cornea) to 2029 ± 463 cells/mm2 at six months. One patient required air re-injection due to partial graft detachment. No other complications were observed.


The first results of the present series suggest that Triple-DMEK is safe and effective in challenging cases of FED and cataract. The ECD loss with the use of the standardized NIIOS techniques in our series was less compared to that in previous reports. Finally, the combination of phacoemulsification and DMEK did not appear to have any negative effect on graft adhesion or the postoperative course.

Financial Interest:


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