Purpose: To evaluate the outcomes of bilateral Descemet membrane endothelial keratoplasty (DMEK) combined with cataract extraction as indicated within a 1- to 2-week timeframe for treatment of Fuchs endothelial corneal dystrophy.
Setting: Private practice, Indianapolis, Indiana, USA.
Design: Case series.
Methods: This retrospective review identified patients who had DMEK in both eyes within 2 weeks.
Results: The study comprised 12 patients (median age 61 years). Seven patients had bilateral DMEK 1 week apart and 5 patients, 2 weeks apart. Twelve eyes had triple procedures (cataract extraction, intraocular lens implantation, DMEK), 7 eyes were pseudophakic before DMEK, and 5 eyes had clear lenses and remained phakic after DMEK. Preoperatively, the median corrected distance visual acuity (CDVA) was 20/40 (range 20/15 to 20/70). By 1 month postoperatively, the median CDVA had improved to 20/25 (range 20/15 to 20/70). The median CDVA in the 10 patients examined between 3 months and 6 months postoperatively was 20/20 (range 20/15 to 20/30). All grafts successfully attached and cleared. Four patients had bilateral air reinjection and 1 patient had unilateral air reinjection to treat partial graft detachment. The rate of air reinjection was comparable between single and triple procedures (P=.65). No other complications were noted.
Conclusions: Patients with bilateral visual impairment associated with Fuchs dystrophy can have both eyes treated with DMEK within 1 to 2 weeks. With DMEK, corneal transplantation begins to approach cataract surgery in the speed of visual recovery and the time to full resumption of daily activities.
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| http://dx.doi.org/10.1016/j.jcrs.2013.03.030 | DOI Listing |
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