Therapie der Fuchs-Endotheldystrophie mittels DMEK

Cursiefen, Claus; Bachmann, Björn

doi:10.1007/s00347-018-0790-1

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…The two main complaints of patients with corneal endothelial diseases are impairment of central visual acuity and glare [ 5 , 6 ]. Since its introduction in 2006 by Gerrit Melles [ 7 ], Descemet membrane endothelial keratoplasty (DMEK) has become the gold standard therapy for corneal endothelial diseases [ 8 – 10 ]. The procedure can be performed stand-alone or in combination with phacoemulsification and intraocular lens implantation (triple-DMEK) [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Descemet membrane endothelial keratoplasty (DMEK) improves vision-related quality of life

Gellert

Unterlauft

Rehák

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate vision-related quality of life (VRQL) before and after Descemet membrane endothelial keratoplasty (DMEK). Methods The study was conducted in patients with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy undergoing DMEK alone or in combination with cataract surgery (triple-DMEK) between August 2019 and March 2020 at the University of Leipzig Medical Center. Best-corrected visual acuity (BCVA) was measured. Visual acuity factor (VAF) and glare factor (GF) scores were calculated using the Visual Function and Corneal Health Status Instrument questionnaire answered by patients before surgery and 6 months thereafter. Subgroup analyses were performed for DMEK versus triple-DMEK, and for first versus second eyes, in addition to correlation analyses of scores with preoperative BCVA. Results Forty-six patients were included in this analysis. VAF score improved from 0.68 ± 0.54 to 0.02 ± 0.57 (P < 0.0001) and GF score improved from 0.53 ± 0.43 to -0.11 ± 0.39 (P < 0.0001) during follow-up. Both scores improved without significant differences after surgery in the first and in the fellow eye (P < 0.0001) and after DMEK and triple-DMEK (P < 0.0001). The improvement of scores did not correlate with preoperative BCVA (r = 0.06, P = 0.68 for VAF; r = -0.09, P = 0.54 for GF). Conclusion VRQL improves similarly after DMEK and triple-DMEK and between first and second operated eye. The extent of improvement is independent of the preoperative BCVA. The results of this study can be useful when planning DMEK by enabling a prediction of anticipated VRQL gain.

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Section: Introductionmentioning

confidence: 99%

Descemet membrane endothelial keratoplasty (DMEK) improves vision-related quality of life

Gellert

Unterlauft

Rehák

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Epithelial downgrowth after Descemet membrane endothelial keratoplasty

Wabnig

Bachmann

et al. 2020

European Journal of Ophthalmology

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Purpose: To describe a patient with epithelial downgrowth after Descemet membrane endothelial keratoplasty. Methods: Case report. Results: A 73-year-old woman underwent triple Descemet stripping automated endothelial keratoplasty for cataract and corneal edema secondary to Fuchs endothelial dystrophy in the left eye elsewhere. Three years later, Descemet membrane endothelial keratoplasty was performed at our department due to graft failure. One month after the operation, her vision improved to 20/32 and maintained stable. At the 14-month visit, her visual acuity decreased, and a routine examination revealed epithelial downgrowth at the posterior surface of the cornea and partly beneath the graft, accompanied by presumed graft rejection. Therefore, repeat Descemet membrane endothelial keratoplasty with epithelial scraping and intracameral injection of 5-fluorouracil was indicated. She recovered 20/25 vision by 1 month after the surgery. However, small sheet-like epithelial downgrowth recurred 1 month later. The epithelial downgrowth was limited to the peripheral margin of the Descemet membrane endothelial keratoplasty graft and did not affect the visual axis. Epithelial downgrowth showed “islands” with connection between epithelial downgrowth and clear corneal incision on anterior segment optical coherence tomography images. Histopathologic evaluation of the removed Descemet membrane endothelial keratoplasty graft confirmed conjunctival epithelium as the source. Under close observation at the current 4-year follow-up, the epithelial downgrowth remained stable and localized and her vision increased to 20/20. Conclusion: Epithelial downgrowth can occur after Descemet membrane endothelial keratoplasty. The limited progression of epithelial downgrowth in this patient suggests that this condition after Descemet membrane endothelial keratoplasty even in the recurrence stage may cause less damage than expected and may only need to be observed closely if no progression occurs.

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Therapie der Fuchs-Endotheldystrophie mittels DMEK

Cited by 2 publications

References 7 publications

Descemet membrane endothelial keratoplasty (DMEK) improves vision-related quality of life

Descemet membrane endothelial keratoplasty (DMEK) improves vision-related quality of life

Epithelial downgrowth after Descemet membrane endothelial keratoplasty

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