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DMEK does not alter corneal biomechanics
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BELGRADE, Serbia — Unlike Descemet’s stripping endothelial keratoplasty, Descemet’s membrane endothelial keratoplasty does not alter the biomechanical properties of the cornea, according to a study presented here at the European Society of Cataract and Refractive Surgeons winter meeting.
“DSEK transplants additional stromal tissue in the eye, while in DMEK there is a 1:1 replacement. This basic difference may not only affect corneal physiology, but also have practical consequences on the reliability of IOP measurements, for instance,” Natalya Shilova, MD, said.
The ability of the cornea to absorb deformation energy was previously proven by ORA studies to be reduced after Descemet’s stripping automated endothelial keratoplasty and refractive surgery and in patients with Fuchs’ dystrophy, keratoconus and glaucoma. This new study used the ORA (Reichert) to evaluate the potential effects of DMEK on corneal hysteresis (CH) and corneal resistance factor (CRF) in patients with unilateral pseudophakic bullous keratopathy. Postoperative measurements were compared with those of the contralateral healthy eye.
Twenty eyes of 10 patients were included, with a mean follow-up of 17 months. In addition to biomechanical parameters, IOP, central corneal thickness (CCT) and visual acuity were measured.
“The postoperative CH and CRF values in the DMEK eyes did not differ significantly from the fellow healthy eyes. VA improved in all eyes after surgery, approaching the values of the contralateral eyes. IOP was comparable. CCT was lower in the DMEK eyes as compared with the healthy contralateral eyes, but no correlation was found with CH or CRF values,” Shilova said.
The normalization of biomechanical properties is in line with the results of previous studies that show near complete visual, functional and ultrastructural rehabilitation of the corneas after DMEK, she said. – by Michela Cimberle
Reference:
Shilova N, et al. Comparison of corneal biomechanical properties of bullous keratopathy corneal following Descemet’s membrane endothelial keratoplasty (DMEK) to their contralateral healthy cornea by ocular response analyzer. Presented at European Society of Cataract and Refractive Surgeons winter meeting; Feb. 9-11, 2018; Belgrade, Serbia.
Disclosure: Shilova reports no relevant financial disclosures.