Official ESCRS | European Society of Cataract & Refractive Surgeons


Refractive precision after combined endothelial DMEK keratoplasty and cataract surgery: multicentre study

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Session Details

Session Title: Combined Cataract Surgery & Practice Styles

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 14:00

Venue: Free Paper Forum: Podium 2

First Author: : G.Boutillier FRANCE

Co Author(s): :    M. Muraine   A. Denoyer   E. Gabison   D. Bernheim   M. Hacquard                 

Abstract Details


The new triple procedures that combine cataract surgery and endothelial graft have reduced postoperative refractive errors. It is now almost possible to target emmetropia. The objective of this study was to evaluate the refractive accuracy after combined endothelial DMEK keratoplasty and cataract surgery.


French Multicentre study: Rouen University Hospital, Reims University Hospital, Grenoble University Hospital and Paris University Hospitals-Fondation Ophtalmologique de Rothschild


One hundred eyes with symptomatic endothelial decompensation mainly in Fuchs endothelial dystrophy and cataract were included. We compared the theoretical refractive target and the actual postoperative refraction at 2 and 6 months postoperatively. Other parameters studied were visual acuity, keratometry, pachymetry and endothelial cell density measured by specular microscopy.


The mean refractive target was -0.48 +/- 0.30 D. The mean spherical refraction obtained was +0.40 +/- 1.25 D at 2 months and +0.48 +/- 0.96 D at 6 months. The refractive error was a mean hyperopia of 0.81 D 95%CI [0.385 ; 1.236] at 2 months and 0.95 D 95%CI [0.562 ; 1.383] at 6 months.The mean keratometry was 44.1 +/- 1.6 D. It decreased by 0.5 D at 2 and 6 months. The mean corrected visual acuity improved in all cases. The mean preoperative pachymetry decreased by 107.4 µm at 2 months and 82.6 µm at 6 months.


The refractive accuracy after the new triple procedure appears lower than before with penetrating keratoplasty. A hyperopic shift was often observed. Furthers studies are necessary to evaluate if this shift persists in the long term in order to include it in the choice of intra ocular lens power.

Financial Disclosure:


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