July 25, 2012
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Triple-DMEK may not hinder endothelial function or graft adhesion

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Descemet’s membrane endothelial keratoplasty combined with simultaneous phacoemulsification and IOL implantation, or triple-DMEK, had no adverse impact on endothelial function or graft adhesion and did not increase the likelihood of postop complications, according to a study.

“Triple-DMEK is not associated with significant changes of refraction or prolonged visual rehabilitation and should be performed in all patients with concomitant endothelial dysfunction and cataract,” the study authors said.

The retrospective, single-center, consecutive case series examined triple-DMEK procedures in 61 consecutive eyes of 56 patients. Main outcomes included the number of air injections necessary for graft attachment, best corrected visual acuity, refractive spherical equivalent, refractive cylinder, endothelial cell density, central corneal thickness, and topographic cylinder measured at 1, 3 and 6 months postop.

At 6 months postop, logMAR BCVA increased from 0.6 ± 0.23 preop to 0.19 ± 0.22 (P ≤ .05). There was no observed increase in endothelial cell loss or complication rate.

“In conclusion, BCVA after triple-DMEK increased within the first 6 months in the same magnitude as in sole DMEK,” study authors wrote. “Whether triple-DSAEK or triple-DMEK becomes the method of choice needs to be determined.”