Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty in Eyes With Previous Radial Keratotomy

Parker, Jack; Parker, John S.; Melles, Gerrit R.J.

doi:10.1097/ico.0000000000001719

Cited by 2 publications

(4 citation statements)

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“…Small case series have demonstrated optimistic reports of DMEK in eyes with corneal structural abnormalities, such as follow radial keratotomy and KCN. 10,11 Eyes with comorbid endothelial dysfunction and KCN exhibit exaggerated depth of the anterior chamber, which may interfere with normal unfolding maneuvers and because visualization of the graft may be obscured by corneal ectasia and stromal scarring. Nevertheless, the advantages that a lamellar procedure may offer over a conventional penetrating graft (including improved visual acuity, diminished risk of allograft reaction and graft rejection, absence of corneal sutures, lower steroid burden, etc.)…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with keratoconus and corneal endothelial dysfunction

Dockery

Parker

Birbal

et al. 2022

European Journal of Ophthalmology

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Purpose To evaluate the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) performed in eyes with comorbid keratoconus (KCN) and corneal endothelial dysfunction. Methods Twenty-five consecutive eyes of 14 patients with comorbid stable KCN underwent DMEK for corneal endothelial dysfunction; best spectacle corrected visual acuity (BSCVA), maximum corneal curvature (Kmax), maximum corneal power (Pmax), central corneal thickness (CCT), and intra- and postoperative complications were assessed. Results Excluding eyes requiring re-transplantation for primary graft failure (n = 3), all eyes showed improvement in BSCVA, reaching ≥ 20/40 (0.5) in 86%, ≥ 20/25 (0.8) in 55%, and ≥ 20/20 (1.0) in 27% by one month postoperatively; 90%, 76%, and 48% by 6 months postoperatively; and 88%, 76%, and 47% by 12 months postoperatively. CCT decreased from 571μm preoperatively to 485μm at 1 month (p < 0.001) and 481μm at 12 months (p < 0.001). Kmax decreased by a median of 1.4 diopters (D) at 1 month (p = 0.003) and 3.1 D at 12 months (p = 0.021), and every eye with a preoperative Kmax ≥ 46 D demonstrated flattening. Pmax decreased by 2.1 D at 1 month (p = 0.001) and 4.0 D at 12 months (p = 0.016). Conclusion DMEK is technically feasible in eyes with comorbid KCN and may give excellent outcomes visual and refractive outcomes, including significant corneal flattening, which may potentially create a visually significant hyperopic shift in patients with severely ectatic corneas.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with keratoconus and corneal endothelial dysfunction

Dockery

Parker

Birbal

et al. 2022

European Journal of Ophthalmology

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“…This leaves a moderate to shallow central AC, but a deep paracentral and peripheral AC, making the elimination of peripheral scrolling of the DMEK graft more difficult. Despite these challenges, several cases have been reported of DMEK under RK [ 5 , 6 ]. In our patient, we used a pilot bubble (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, our patient’s preoperative astigmatism was + 1.25 diopters, which decreased to + 0.75 diopters at the three-month postoperative visit. Though generally endorsed as a refractively near-neutral surgery, DMEK may potentially reshape the corneal surface, especially in eyes that have undergone anterior corneal manipulation [ 6 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Descemet membrane endothelial keratoplasty in a patient with iris-fixated intraocular lens and prior radial keratotomy: a case report

et al. 2021

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Background Anterior segment surgeries such as cataract surgery, intraocular lens (IOL) repositioning, and radial keratotomy (RK) may hasten endothelial dysfunction, particularly in the context of pre-existing Fuchs dystrophy, necessitating future corneal transplantation. Case presentation A 68-year-old woman with a history of RK with associated irregular astigmatism in both eyes and iris-fixated intraocular lens (IF-IOL) in the left eye presented with six months of decreased vision in the left eye. She was found to have Fuchs dystrophy and underwent DMEK surgery. She had an uncomplicated postoperative course, with uncorrected visual acuity improving to 20/20 three months after surgery. Conclusion To our knowledge, this is the first reported case of a highly successful DMEK surgery in a patient with prior RK and IF-IOL.

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Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty in Eyes With Previous Radial Keratotomy

Abstract: DMEK is technically feasible in eyes with previous RK and may provide excellent outcomes. A significant change in the anterior corneal contour and associated refractive power of the eye may be anticipated depending on the amount of preoperative corneal edema and the number of RK incisions.

Cited by 2 publications

References 11 publications

Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with keratoconus and corneal endothelial dysfunction

Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with keratoconus and corneal endothelial dysfunction

Descemet membrane endothelial keratoplasty in a patient with iris-fixated intraocular lens and prior radial keratotomy: a case report

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