Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty as a Staged and Solitary Procedure

Flanary, William E.; Vislisel, Jesse M.; Wagoner, Michael D.; Raecker, Matthew E.; Aldrich, Benjamin T.; Zimmerman, M. Bridget; Goins, Kenneth M.; Greiner, Mark A.

doi:10.1097/ico.0000000000000870

Cited by 32 publications

(21 citation statements)

References 24 publications

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“…In a large prospective study involving 155 eyes, Heinzelmann et al 11 reported a post-DMEK CME incidence of 13%, with no significant difference in the CME incidence after DMEK and triple-DMEK. More recently, Hoerster et al 12 reported a CME incidence of 12% in a study that included 75 eyes, and Flanary et al 13 reported an incidence of 7.5% in a study that included 173 eyes.…”

Section: Discussionmentioning

confidence: 99%

“…Our study found that the incidence of CME after DMEK is generally high and that there is not a “typical” patient who develops it. Flanary et al 13 examined post-DMEK CME incidence in patients who had recently (between 2 wk and 6 mo) and remotely (>6 mo) undergone cataract surgery. In agreement with our findings, these pseudophakic eyes had a CME incidence of 7.5%, with no significant difference between groups.…”

Section: Discussionmentioning

confidence: 99%

“…Heinzelmann et al 11 and Hoerster et al 12 reported similar CME incidences of 13% (20 of 155 eyes) and 12% (9 of 75 eyes), respectively. By contrast, Flanary et al, 13 Dapena et al, 14 and Chaurasia et al 15 reported an incidence of 7.5% (13 of 173 eyes), 0.7% (1 of 135 eyes), and 1% (3 of 292 eyes), respectively, in eyes that underwent DMEK. In addition, Chaurasia et al 15 observed a CME incidence of 1.5% (3 of 200 eyes) in eyes that underwent concurrent DMEK/cataract surgery.…”

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confidence: 93%

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Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Kocaba

Mouchel

Fleury

et al. 2018

Cornea

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Purpose:The incidence of and risk factors for cystoid macular edema (CME) after Descemet membrane endothelial keratoplasty (DMEK) remain uncertain. This study examines the incidence of and risk factors for CME after DMEK.Methods:This retrospective, single-center study included patients with no history of CME who had undergone DMEK. Patients were examined weekly for 1 month after surgery and at 3 and 6 months after surgery. Follow-up examinations included visual acuity (VA) assessment, pachymetry, anterior segment optical coherence tomography, biomicroscopy, intraocular pressure measurement, and fundoscopy. Eyes suspected of having CME (reduced VA and/or abnormal fundoscopic findings) underwent macular optical coherence tomography. Potential risk factors for CME examined included age, axial length, anterior chamber rebubbling, not using a topical nonsteroidal antiinflammatory after surgery, and concurrent DMEK and cataract surgery (triple-DMEK).Results:Eighty eyes (74 subjects) were included. Eleven eyes (13.8%) developed CME within 6 months after undergoing DMEK. Univariate analyses did not identify any significant CME risk factors. Interestingly, the triple-DMEK procedure did not put subjects at risk for developing CME (P = 0.184). Visual prognosis after medical treatment for CME was excellent, and subjects with and without CME had comparable VA at 6 months [CME: logarithm of the minimum angle of resolution (logMAR) VA = 0.3 (first–third quartile: 0.1–1.0), 20/40; no CME: logMAR VA = 0.3 (0.1–0.5), 20/40; P = 0.391].Conclusions:Although CME frequently occurred after DMEK, no CME risk factors were identified. In addition, CME did not significantly affect long-term visual outcomes when it was appropriately treated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

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Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Kocaba

Mouchel

Fleury

et al. 2018

Cornea

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“…This is the typical approach to cases of concurrent cataract and corneal edema at our institution. 1 Advantages of staging the DMEK surgery include improved intraoperative iris control, which we felt was a distinct advantage given the limited predictability of iris behavior after iridectomy in the context of the patient's iridoschisis.…”

Section: Discussionmentioning

confidence: 99%

“…One month later, uncomplicated DMEK was performed in the right eye using our previously published technique. 1 Graft edge lifts were not noted. One month after DMEK in the right eye, BCVA was 20/30, slit lamp examination showed an attached DMEK graft with clear overlying stroma, and CCT was 538 μm ( Fig.…”

Section: Case Reportmentioning

confidence: 99%

Descemet membrane endothelial keratoplasty for corneal decompensation due to iridoschisis

Greenwald

Niles

Johnson

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report a case of bilateral iridoschisis with cataracts and corneal decompensation in a patient who underwent cataract extraction and superficial iridectomy followed by Descemet membrane endothelial keratoplasty (DMEK).ObservationsA 58-year-old man with previously diagnosed iridoschisis, cataracts, and diabetes mellitus experienced progressive vision loss bilaterally due to corneal decompensation. Slit lamp examination revealed iridoschisis with iris fibrils contacting the corneal endothelium, stromal edema, and mild guttate changes bilaterally. Corneal findings were more severe in the right eye, including the presence of bullous keratopathy at the time of presentation. Cataract extraction with intraocular lens implantation and superficial iridectomy were performed in the right eye, followed by DMEK. These same procedures were performed subsequently in the left eye. Postoperatively, the patient had significant improvement in visual acuity and corneal edema.Conclusions and importanceDMEK can be performed safely and successfully after staged cataract surgery with superficial iridectomy in eyes with endothelial decompensation caused by iridoschisis.

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Cataract Surgery in Eyes with Fuchs Endothelial Corneal Dystrophy

Tourtas

Weller²,

Kruse³

2022

Cataract Surgery

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Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty as a Staged and Solitary Procedure

Abstract: The incidence of postoperative CME after DMEK is similar in the setting of recent or remote cataract surgery.

Cited by 32 publications

References 24 publications

Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Descemet membrane endothelial keratoplasty for corneal decompensation due to iridoschisis

Cataract Surgery in Eyes with Fuchs Endothelial Corneal Dystrophy

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