Posters

Comparison of Descemet's membrane endothelial keratoplasty (DMEK) and ACIOL exchange with Descemet's stripping automated endothelial keratoplasty (DSAEK) and ACIOL retention in the setting of pseudophakic bullous keratopathy

Poster Details

First Author: B.Dubinsky-Pertzov ISRAEL

Co Author(s):    G. Santaella   M. Safir   L. Or   N. Sorkin   D. Rootman   A. Einan-Lifshitz     

Abstract Details

Purpose:

To evaluate clinical outcomes and complications of Descemet membrane endothelial keratoplasty (DMEK) and anterior chamber intra ocular lens (ACIOL) exchange with Descemet stripping automated endothelial keratoplasty (DSAEK) and ACIOL retention in patients with pseudophakic bullous keratopathy (PBK).

Setting:

Public healthcare center, Assaf Harofeh medical center, Zerifin, Israel and Toronto Western Hospital, Toronto, Canada.

Methods:

In this multicenter retrospective cohort study we identified all patients with ACIOL who underwent endothelial keratoplasty (EK) procedure due to PBK between 2010 and 2018 in two tertiary medical centers. The following data were collected: clinical and demographical data, type of procedure - DMEK and ACIOL exchange, group-A, or DSAEK and ACIOL retention, group-B, graft characteristics and post-operative data including best corrected visual acuity (BCVA), rebubbling rate, graft rejection and graft failure events.

Results:

Fourteen eyes in group-A and 12 in group-B were included in the analysis. Median BCVA 6 months post-operatively was 0.45 (range 0.4-2) and 0.54 (range 0.3-2) logMAR (Snellen equivalent 20/56 and 20/69) in group A and B, respectively (P=0.36). Three eyes in group-A (25%) and 4 eyes in group-B (28.5%) required rebubbling. Graft failure requiring another corneal transplant occurred in 5 eyes in group-A (35.7%) at an average follow-up time of 15.9 months, all except for one were secondary failures. In group-B, graft failure occurred in one eye and was a primary failure (8.3%) (survival analysis P=0.23).

Conclusions:

The higher rates of graft failure and the need for second keratoplasy, although not significant, might suggest that in the indication of PBK, DMEK with ACIOL exchange could provide a good alternative to DSAEK and IOL retention.

Financial Disclosure:

None