Clinical outcomes after Descemets Membrane Endothelial Keratoplasty with Stromal Rim surgery combined with cataract extraction

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Clinical outcomes after Descemets Membrane
Endothelial Keratoplasty with Stromal Rim surgery
combined with cataract extraction

• Magdaléna Netuková, Deli Siveková, Katerina
  Liehneová Magdalena Vokrojová, Pavel Studený
• Dpt. of Ophthalmology, Vinohrady Teaching
  Hospital
• Srobarova 50, 100 34 Prague 10, Czech Republic
• Authors have NO finatial interest

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Aim of the study

• To present clinical outcomes of patients who
  underwent Descemets Membrane Endothelial
  Keratoplasty with Stromal Rim (DMEK-S) combined
  with cataract extraction in a single surgery
• To evaluate safety and efficacy of this tripple
  procedure

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Patients and Methods

• Retrospective nonrandomized single center study
• 30 eyes of 25 patients were enrolled
• 14 female, 11 male
• Indication for this surgery was cataract with
  endothelial dystrophy
• Mean age was 68 years (55-78 years)
• Mean follow-up time was 15 months (9-26 months)

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Fuchs endothelial dystrophy
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Methods - pocedure

• Standard Cataract surgery with single-piece
  Hyrophobic Acrylic IOL implantation
• Profound removal of all viscoelastic material
• Descemetorhexis with help of Trypan Blue staining
• Preparation of donor Descemets Membrane with
  stromal rim (details Studeny P., et al., Br. J.
  Ophthalmol., 2009)
• Implantation of the Membrane
• Fixation of the Membrane with Air bubble

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Results
UCVA BCVA SE
Preop 0,26 (0,14 SD) 0,35 (0,14 SD) -0,07 D (1,21 SD)
Postop 0,64 (0,24 SD) 0,81 (0,21 SD) 0,21 D (0,6 SD)
Endothelial Cell Dednsity postop 983 bb/mm2
(270,03 SD)
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Complications

• Peroperative
• No major peroperative complications were detected
• Postoperative
• In 6 eyes air had to be reinjected, usually
  because of partial graft detachments
• 3 grafts failed to clear and required an exchange

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Conclusion

• Our experience shows, that the combination of
  DMEK-S and cataract surgery is safe and effective
  procedure for the patient
• Strictly individual aproach to each patient is
  necessary
• Good patients compliance is important

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Thank you
Magdalena Netukova, MD PhD Dpt. of
Ophthalmology Vinohrady Teaching
Hospital Srobarova 50, 100 34 Prague 10 Czech
Republic E-mail netukova_at_fnkv.cz