Bilateral Descemet's membrane endothelial keratoplasty in a young adult for Fuchs' dystrophy after several excimer surgeries

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : A.Slavik Lencova GERMANY

Co Author(s): :    I. Schmack   T. Kohnen                    

Abstract Details

Purpose:

To report a case of bilateral DMEK surgery of a young female patient with Fuchs endothelial dystrophy after multiple bilateral laser refractive surgeries for hyperopia correction.

Setting:

Goethe University, Frankfurt am Main, Germany

Methods:

In August 2016, a 32-year-old female patient came to our department with progressive vision deterioration after two previous LASIK treatments in 2004 and one LASEK treatment in 2015 for hyperopia. The best corrected visual acuity (BCVA) was 0.40 (D) in both eyes. The slit lamp examination showed diffuse cornea guttata, without corneal edema and a normal flap. Endothelial cell count was not measurable. After 6-months follow-up the symptoms and signs remained. Therefore, the patient underwent DMEK surgery on her left eye in April 2017, and on her right eye in January 2018.

Results:

The bilateral DMEK surgery, despite flat anterior chamber, was uneventful. The DMEK graft remained attached. The patient was very satisfied subjectively. The BCVA was 0.80 in the left eye 10 months postoperatively, and 0.60 in the right eye 1 month postoperatively. The slit-lamp examination showed a clear cornea and DMEK graft bilateral. The endothelial cell density was 1872 cells/mm2 in the left eye and 1240 cells/mm2 in the right eye during the last check-up. The preoperative central corneal thickness was 563 μm in the left eye, and 557 μm in right eye, compared to 577 μm and 543 μm postoperatively.

Conclusions:

In this case, the multiple laser refractive surgeries most likely decompensated the Fuchs endothelial dystrophy. The bilateral DMEK surgery was successful for the treatment of this decompensation and led to visual improvement.

Financial Disclosure:

None