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Refractive stability after Descemet"s membrane endothelial keratoplasty (DMEK)

Session Details

Session Title: Cornea surgical I

Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30

Paper Time: 10:18

Venue: Forum (Ground Floor)

First Author: : M.RodrÄ·guez Calvo de Mora SPAIN

Co Author(s): :    K. van Dijk   L. Ham   L. Baydoun   V. Liarakos   I. Dapena   G.

Abstract Details

Purpose:

To determine the refractive change and stability up to two years after Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Non-randomized, prospective clinical study, at a tertiary referral center. Netherlands Institute for Innovative Ocular Surgery, Rotterdam.

Methods:

From 149 (pseudo)phakic DMEK eyes with complete follow-up data up to two years after surgery, best-spectacle corrected visual acuity, complete subjective refractive and Pentacam data were obtained before, and 3, 6, 12 and 24 months after surgery.

Results:

A mild hyperopic shift in the spherical equivalent (SE) of about +0.4D on average could be found after three months and a mean change in refractive cylinder of about -0.3D. The refraction stabilized at three months postoperatively and no significant change in subjective refraction was observed up to two years after DMEK. Pentacam showed an average decrease in true net power of about 1D after surgery. Pachymetry decreased from 668 µm (± 94 µm) before, to 524 µm (± 50 µm) after three months.

Conclusions:

DMEK may give a minimal pre- to postoperative refractive change and stabilization thereof at three months. Refraction seems stable up to at least two years after DMEK. The small hyperopic shift after DMEK might result from a reversal of a preceding myopic shift induced by stromal swelling in endothelial disease. If so, normal intraocular lens power nomograms apply for cataract surgery prior to, during or after DMEK.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented


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