Original articleDescemet Membrane Endothelial Keratoplasty Combined With Phacoemulsification and Intraocular Lens Implantation: Advanced Triple Procedure
Section snippets
Patients
Triple-DMEK (DMEK with simultaneous cataract surgery) was performed in 61 consecutive eyes of 56 patients (37 eyes of 34 male patients, and 24 eyes of 22 female patients) aged between 42 and 79 years (mean age 66.3 ± 12.4 years). Indications for surgery were Fuchs endothelial dystrophy (n = 60) and bullous keratopathy after failed DMEK (n = 1). Thirty-two eyes received an isolated endothelium–Descemet membrane layer prepared from a corneoscleral button that had been stored in Optisol-GS (Bausch
Visual Outcome
The BCVA achieved following DMEK is shown in Figure 1. For final analysis 6 patients were excluded because of preexisting conditions limiting visual potential: macular degeneration (n = 3), epiretinal gliosis with cystoid macular edema (n = 1), advanced glaucomatous optic atrophy (n = 1), and prior retinal surgery because of retinal detachment (n = 1). BCVA was 0.6 ± 0.23 logMAR preoperatively (n = 54) and increased to 0.31 ± 0.18 logMAR at 1 month (n = 47), to 0.23 ± 0.23 logMAR at 3 months (n
Discussion
Endothelial keratoplasty such as DSAEK or DMEK has become the procedure of choice in surgical management of corneal endothelial diseases such as Fuchs endothelial dystrophy. There is a consensus about advantages of endothelial keratoplasty compared to penetrating keratoplasties because of faster visual rehabilitation, reduced postsurgical astigmatism, and reduced risk for expulsive hemorrhages.7, 10, 12, 17, 33, 34
In patients with corneal disease and cataract a combined surgical approach
Kathrin Laaser, MD, graduated from Munich Medical School (Technical University) in 2005. Since 2006 she has been a staff member of the Department of Ophthalmology at the University of Erlangen/Nuremberg, Erlangen, Germany. Dr Laaser is currently receiving a fellowship training in corneal diseases at the Department of Ophthalmology, Erlangen University Medical School.
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Kathrin Laaser, MD, graduated from Munich Medical School (Technical University) in 2005. Since 2006 she has been a staff member of the Department of Ophthalmology at the University of Erlangen/Nuremberg, Erlangen, Germany. Dr Laaser is currently receiving a fellowship training in corneal diseases at the Department of Ophthalmology, Erlangen University Medical School.
Friedrich E. Kruse, MD, is Professor and Chairman, Department of Ophthalmology, Erlangen University Medical School, Germany since 2004. After graduation from Heidelberg Medical School in 1984, he worked from 1988 to 1991 at the Bascom Palmer Eye Institute, Miami/Florida. His research interests include cellular and molecular biology of the ocular surface corneal transplantation and laser application.