Mini descemet membrane stripping (m-DMES) in patients with Fuchs’ endothelial dystrophy: A new method

Abstract

We present two cases with focal corneal edema due to Fuchs' endothelial dystrophy that were successfully treated with mini Descemet membrane stripping (m-DMES) (diameter of 3-4 mm; at the area of preexisting focal corneal edema) without endothelial replacement during cataract surgery. Specular microscopy demonstrated Fuchs' endothelial dystrophy and histopathologic evaluation confirmed the diagnosis. Anterior segment optical coherence tomography and confocal microscopy were used for the evaluation of the corneal tissue recovery course after the surgical procedure. In both patients, we observed an initial aggravation of corneal edema in the area of DM removal for two months followed by gradual improvement. At four months postoperatively, corneal edema had completely regressed resulting in corneal clearance and visual acuity improvement in both cases. M-DMES without graft insertion represents a promising alternative surgical technique that could be applied in specific cases of Fuchs' endothelial dystrophy with focal corneal edema.

Descemetorhexis Without Endothelial Keratoplasty in Fuchs Endothelial Corneal Dystrophy: A Systematic Review and Meta-Analysis

“…Overall, 118 patients were included, ranging from 2 42,43 to 23 45 patients per included study, and 127 eyes were treated, ranging from 2 42,43 to 23 45 per study. Among the 127 eyes treated, 38 underwent DWEK ± RHOKI, 68 underwent DWEK ± PKE, and 21 underwent DWEK ± PKE ± RHOKI.…”

“…Other postoperative treatments could include a topical antibiotic 35,38,40,42–45 (gatifloxicin, 35 tobramycin, 35,38 ofloxacine, 42 moxifloxacin, 39 and/or chloramphenicol 43–45 ), topical corticosteroids 35,36,38,40,42–45 (1% prednisolone acetate 35,36,39,42 and/or dexamethasone 35,38,43–45 ), and sometimes topical nonsteroidal antiinflammatory drugs 40,43–45 (ketorolac 44,45 or nepafenac 43 ), 5% NaCl 35,38,39,44,45 drops or ointment, artificial tears, or bandage soft lenses. 35…”

“…The average age of the patients was 66.1 ± 5.8 years, varying from 43.7 ± 3.2 35 to 72 ± 0 years. 43…”

“…Eleven articles were included in our systematic review. [35][36][37][38][39][40][41][42][43][44][45] All of these 11 articles were written in English except for 1, which was in Russian. 40 Six articles came from North America, 35,37,39,41,42 from Europe, 38,43 2 from Oceania, 44,45 and 1 from Asia.…”

“…[35][36][37][38][39][40][41][42][43][44][45] All of these 11 articles were written in English except for 1, which was in Russian. 40 Six articles came from North America, 35,37,39,41,42 from Europe, 38,43 2 from Oceania, 44,45 and 1 from Asia. 40…”