Refraktive Veränderungen bei Triple-Descemet-Membran-Endothel-Keratoplastik

Girbardt, Christian; Oertel, Nicole; Adamek-Dyk, J; Wiedemann, Peter; Nestler, A.

doi:10.1007/s00347-015-0201-9

Cited by 5 publications

(11 citation statements)

References 12 publications

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“…Eyes after DMEK are also subject to a hyperopic shift after IOL implantation. However, the change of total corneal refractive power is markedly smaller (about 0.5 D) in DMEK than in DSAEK [42,43].…”

Section: Descemet's Membrane Endothelial Keratoplasty (Dmek)mentioning

confidence: 81%

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

Eppig¹,

Mäurer²,

Daas³

et al. 2018

OCT - Applications in Ophthalmology

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Anterior segment OCT (AS-OCT) is an optical and noncontact imaging technology, which has numerous fields of application in the imaging of the cornea, anterior chamber, and the lens. In this chapter, we will present some of the application fields of AS-OCT in corneal, cataract, and refractive surgery. We will emphasize the potential of AS-OCT by several clinical examples including corneal imaging (keratoconus, keratoplasty, and refractive surgery) and intraocular lens imaging after refractive surgery. AS-OCT shows special potential for corneal imaging in case of corneal edema and for postoperative control after Descemet's membrane endothelial keratoplasty (DMEK). The postoperative follow-up of a posterior chamber Collamer lens'ses vault and measuring the anterior chamber angle could be identified as another promising field of application for AS-OCT.

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Section: Descemet's Membrane Endothelial Keratoplasty (Dmek)mentioning

confidence: 81%

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

Eppig¹,

Mäurer²,

Daas³

et al. 2018

OCT - Applications in Ophthalmology

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“…21,22,24,25,27,33,35,36,38,42 In 8 (27.6%) studies with tomographic analysis, however, there was a statistically significant steepening of posterior corneal topography. 20,21,23,24,39,41,42,46 In a study of 87 pseudophakic eyes undergoing DMEK, Agha et al reported that postoperative changes were mainly observed in the posterior corneal surface, with a statistically significant reduction of posterior corneal astigmatism from 0.59 ± 0.56 D to 0.39 ± 0.27 D. 24 Moreover, the authors observed an increase in the number of eyes exhibiting an against-the-rule astigmatism from 42.8% to 73.6%, although the proportion of eyes with with-the-rule and oblique astigmatism decreased after DMEK. 24 By contrast, the postoperative change in the anterior corneal curvature was inconsistent throughout the literature, with only 2 studies (6.9%) reporting a significant difference, whereas 5 studies (17.2%) did not.…”

Section: Discussionmentioning

confidence: 99%

“…[52][53][54] Moreover, in cases of preoperative corneal edema, the increase in corneal hydration of the posterior stroma has been shown to cause a slight decrease in the overall corneal refractive index, which needs to be considered as well. 41 Another way to optimize the IOL power calculation in patients undergoing triple DMEK is to use the refractive shift of the first eye after DMEK as an orientation to predict the refractive shift and optimize the refractive target of the second eye. 26 In fact, it was recently reported that the extent of refractive shift after triple DMEK in the second eye was comparable with that of the first eye (paired analysis: mean difference 0.49 ± 0.43 D).…”

Section: Discussionmentioning

confidence: 99%

Refractive outcomes after DMEK: meta-analysis

Augustin

Son

Yildirim

et al. 2023

J Cataract Refract Surg

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In this meta-analysis and systematic literature review of refractive outcomes after Descemet membrane endothelial keratoplasty (DMEK), the extent of the refractive shift and an overview of reasons for refractive shift after DMEK are provided. The PubMed library was screened for articles containing the terms “Descemet membrane endothelial keratoplasty,” “DMEK,” “Descemet membrane endothelial keratoplasty combined with cataract surgery,” “triple-DMEK” combined with “refractive outcomes,” “refractive shift,” and “hyperopic shift.” The refractive outcomes after DMEK were analyzed and compared using a fixed and random effects model. The overall mean change of the spherical equivalent outcome when compared with the preoperative value in cases of DMEK or when compared with the preoperative target refraction in cases of DMEK combined with cataract surgery was +0.43 diopters (D) (95% CI, 0.31-0.55). When DMEK is combined with cataract surgery, a target refraction of −0.5 D is recommended to achieve emmetropia. Changes in the posterior corneal curvature are identified as the main cause of the refractive hyperopic shift.

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“…Ein bekanntes Phänomen nach DMEK stellt die Hyperopisierung um durchschnittlich ca. 0,6 dpt dar [28][29][30][31]. Bei der Wahl der Intraokularlinse für die Triple-DMEK (Kataraktoperation kombiniert mit DMEK) muss dies entsprechend berücksichtigt werden, sodass bspw.…”

Section: Postoperative Komplikationenunclassified

DMEK: Probleme vermeiden, erkennen, lösen

Bachmann

Schrittenlocher

Schaub

et al. 2017

Klin Monatsbl Augenheilkd

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Descemet membrane endothelial keratoplasty (DMEK) has evolved into a routine surgical procedure for posterior lamellar keratoplasty. After its introduction more than 10 years ago, several modifications in grafting technique and postoperative treatment regimen helped to improve its safety and reproducibility. Although DMEK offers faster and better improvements in visual acuity, as well as less graft rejections when compared to Descemet's stripping (automated) endothelial keratoplasty (DS[A]EK), difficulties when implementing this technique hamper the widespread use in many areas. However, different strategies help to reduce the rate of intra- and postoperative complications, making DMEK the method of choice for most patients with corneal endothelial diseases. Certain techniques help to reduce the endothelial damage during graft preparation; correct matching of donor age and recipient's anterior chamber depth eases intracameral unfolding of the DMEK graft, the use of SF gas for anterior chamber tamponade reduces the need for additional rebubblings, and the correct frequency and duration of postoperative topical steroid treatment helps to reduce the development of cystoid macular edema and graft rejections. Further standardization, but also individualization, of DMEK helps to offer this treatment option to patients with more complex anterior segment situations like anterior synechia, larger iris defects and glaucoma drainage devices.

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Refraktive Veränderungen bei Triple-Descemet-Membran-Endothel-Keratoplastik

Cited by 5 publications

References 12 publications

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

Refractive outcomes after DMEK: meta-analysis

DMEK: Probleme vermeiden, erkennen, lösen

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