Magdaléna Netuková, Deli Siveková , Katerina Liehneová Magdalena Vokrojová , Pavel Studený
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Transcript of Magdaléna Netuková, Deli Siveková , Katerina Liehneová Magdalena Vokrojová , Pavel Studený
Clinical outcomes after DClinical outcomes after Descemets escemets MMembrane Endothelial Keratoplasty embrane Endothelial Keratoplasty with Stromal Rim with Stromal Rim surgery combined surgery combined
with cataract extractionwith cataract extraction
Magdaléna Netuková, Deli Siveková, Katerina Liehneová Magdaléna Netuková, Deli Siveková, Katerina Liehneová Magdalena Vokrojová, Pavel StudenýMagdalena Vokrojová, Pavel Studený
Dpt. of Ophthalmology, Vinohrady Teaching HospitalDpt. of Ophthalmology, Vinohrady Teaching HospitalSrobarova 50, 100 34 Prague 10, Czech RepublicSrobarova 50, 100 34 Prague 10, Czech Republic
Authors have NO finatial interestAuthors have NO finatial interest
Aim of the studyAim of the study To present clinical outcomes To present clinical outcomes ofof patients who patients who
underwent Dunderwent Descemets escemets MMembrane embrane EEndothelial ndothelial KKeratoplasty with Stromal Rim (DMEKeratoplasty with Stromal Rim (DMEK-S-S)) combined with cataract extraction in a single combined with cataract extraction in a single surgerysurgery
To evaluate safety and efficacy of this tripple To evaluate safety and efficacy of this tripple procedureprocedure
Patients and Methods Patients and Methods
RRetrospective nonrandomized single center etrospective nonrandomized single center studystudy
30 eyes of 25 patients were enrolled30 eyes of 25 patients were enrolled 14 female, 11 male 14 female, 11 male Indication for this surgery was cataract with Indication for this surgery was cataract with
endothelial dystrophyendothelial dystrophy Mean age was 68 years (55-78 years)Mean age was 68 years (55-78 years) Mean follow-up time was 15 months (9-26 Mean follow-up time was 15 months (9-26
months)months)
Fuchs endothelial dystrophy
Methods - pocedure Methods - pocedure Standard Cataract surgery with single-piece Standard Cataract surgery with single-piece
Hyrophobic Acrylic IOL implantationHyrophobic Acrylic IOL implantation Profound removal of all viscoelastic material Profound removal of all viscoelastic material Descemetorhexis with help of Trypan Blue Descemetorhexis with help of Trypan Blue
stainingstaining Preparation of donor Descemets Membrane Preparation of donor Descemets Membrane
with stromal rim with stromal rim (details – Studeny P., et al., Br. J. Ophthalmol., 2009)(details – Studeny P., et al., Br. J. Ophthalmol., 2009)
Implantation of the MembraneImplantation of the Membrane Fixation of the Membrane with Air bubbleFixation of the Membrane with Air bubble
ResultsResults
UCVAUCVA BCVABCVA SESE
PreopPreop 0,260,26 (±0,14 SD)(±0,14 SD) 0,350,35 (±0,14 SD)(±0,14 SD) -0,07 D-0,07 D (±1,21 SD)(±1,21 SD)
PostopPostop 0,640,64 (±0,24 SD)(±0,24 SD) 0,810,81 (±0,21 SD)(±0,21 SD) +0,21 D+0,21 D (±0,6 SD)(±0,6 SD)
Endothelial Cell Dednsity postop:Endothelial Cell Dednsity postop:
983 bb/mm983 bb/mm22 (±270,03 SD)(±270,03 SD)
ComplicationsComplications
Peroperative:Peroperative: No major peroperative complications were No major peroperative complications were
detecteddetected
Postoperative:Postoperative: In 6 eyes air had to be reinjected, In 6 eyes air had to be reinjected, usually usually
because of partial because of partial graft graft detachmentsdetachments 3 grafts failed to clear and required an exchange3 grafts failed to clear and required an exchange
ConclusionConclusion
Our experience shows, that the combination Our experience shows, that the combination of of DMEK-S and cataract surgery DMEK-S and cataract surgery is safe is safe and effectiveand effective procedure procedure for the patient for the patient
Strictly individual aproach to each patient is Strictly individual aproach to each patient is necessarynecessary
Good patient´s compliance is importantGood patient´s compliance is important
Thank youThank you
Magdalena Netukova, MD PhDMagdalena Netukova, MD PhDDpt. of OphthalmologyDpt. of OphthalmologyVinohrady Teaching HospitalVinohrady Teaching HospitalSrobarova 50, 100 34 Prague 10Srobarova 50, 100 34 Prague 10Czech RepublicCzech RepublicE-mail: [email protected]: [email protected]