Cystoid macular edema after uncomplicated Descemet's membrane endothelial keratoplasty

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Tuesday 08/09/2015 | 08:00-10:30

Paper Time: 09:48

Venue: Room 10

First Author: : M.Arino SPAIN

Co Author(s): :    B. Garcia Sandoval   I. Jimenez-Alfaro   N. Alejandre   D. Mingo   S. Duran        

Abstract Details

Purpose:

The purpose of this study is to determine the incidence of Cystoid Macular Edema (CME) and to define potential risk factors following Descemet Membrane Endothelial Keratoplasty (DMEK).

Setting:

31charts were reviewed at the Hospital Fundación Jiménez Diaz in Madrid, Spain

Methods:

32 eyes of 31 patients suffering from Fuchs endothelial dystrophy (65%), bullous keratopathy (25%) and corneal decompensation secondary to herpetic endotheliitis (3%) underwent uncomplicated DMEK. All of them were pseudophakic. Spectral-domain optical coherence tomography (SD-OCT) was performed in scheduled visits due to limited or decreased visual acuity. The medical records were reviewed for pre-existing comorbidities limiting visual acuity. Potential risk factors for CME were analyzed

Results:

All patients improved Best Corrected Visual Acuity (BCVA) by six month. Two patients had limited improvement (20/250)due to myopic maculopathy and sub-epithelial fibrosis due to chronic corneal edema. SD-OCT showed CME in 4 patients (12,5%). CME occurred within the month in two patients (patient one had history of herpetic disease that was not active at the time of CME presentation and patient two had an epirretinal membrane), Two other patients had a rejection episode at the time of CME at 6 and 12 months of surgery. They all responded well to topical non-steroidal anti-inflammatory agents and sub-tenon steroid injection

Conclusions:

CMO is not a rare complication following DMEK in pseudophacic eyes. The prognosis is very good given medical treatment. We recommend using topical NSAIDs to prevent inflammation and CME after routine DMEK surgery and SD-OCT monitoring during the first 12 months following DMEK

Financial Interest:

NONE