Official ESCRS | European Society of Cataract & Refractive Surgeons


Comparison of clinical outcomes of Descemet’s membrane endothelial keratoplasty (DMEK) vs DMEK combined with cataract surgery in Fuchs' endothelial dystrophy

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Session Details

Session Title: Cornea Surgical: Lamellar Corneal Grafts

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 08:36

Venue: Free Paper Forum: Podium 3

First Author: : D.Shahnazaryan UK

Co Author(s): :    A. Hajjar Sese   E. Hollick                          

Abstract Details


To assess outcomes 1 month and 1 year after DMEK in comparison with combined phacoemulsification and DMEK in patients with Fuchs endothelial dystrophy (FED).


Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK


Prospective UK data of 124 eyes (90 patients) with FED undergoing DMEK with or without concurrent cataract surgery with at least 1 months follow up were included in this review. Main outcomes included vision, central corneal thickness (CCT), complications and percentage endothelial cell loss (ECL). Surgical trauma was scored on a scale of 0 to 10.


40 eyes had DMEK only and 84 had DMEK combined with cataract surgery. Percentage ECL was lower in the DMEK alone group compared with DMEK phaco at 1 month (23.6 ± 19.7 vs 34.7 ± 13.6; p<0.01) and 12 months (29.3 ± 16.0 vs 39.2 ± 14.7; p=0.058). 8% of DMEK phaco cases had trauma scores above 4 compared to none of the DMEK cases. Visual outcomes were comparable. All DMEK grafts were functioning at 1 year, whereas 3 of the combined cases failed and required reoperation.


Mean ECL was significantly greater after combined DMEK phaco than after DMEK surgery alone. 4% of the combined cases failed in the first year compared to none of the DMEK cases. Combined DMEK phaco cases can have more surgical trauma than DMEK alone causing greater damage to the endothelial cells

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