Phaco-DMEK with Vivity IOL implantation shows good outcomes in Fuchs’ dystrophy patients
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Key takeaways:
- Combined phaco-DMEK leads to equally good vision as phaco and DMEK performed separately.
- The decrease in endothelial cell count was greater in the group with separate procedures.
VILAMOURA, Portugal — At a time when more patients want to minimize the use of spectacles, cataract surgery with implantation of a Vivity IOL is an option in eyes with Fuchs’ dystrophy.
Phaco-DMEK as a combined procedure leads to equally good vision and is more respectful of the endothelium as compared with Descemet’s membrane endothelial keratoplasty and phacoemulsification performed separately, according to a study presented here.
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“DMEK has become our procedure of choice and is gradually taking over from DSAEK in our hospital, where we carry out about 1,800 keratoplasty procedures per year,” Álvaro Sánchez Ventosa, MD, said at the European Society of Cataract and Refractive Surgeons winter meeting.
In two groups of patients with Fuchs’ dystrophy with similar characteristics in terms of age, refractive error and topography, the outcomes of phaco-DMEK and DMEK followed by cataract surgery after 3 months were compared. In both groups, the Vivity IOL (Alcon) was implanted.
“The study is ongoing. We are aiming at including at least 30 eyes, and here we are presenting our interim results of six and seven patients, respectively,” Sánchez Ventosa said.
After surgery, the decrease in endothelial cell count was greater in the group in which the procedures were performed separately, leading to a mean of 1,332 cells/mm2 as compared with 1,928 cells/mm2 in the phaco-DMEK group.
“And to our surprise, while we expected to achieve better visual outcomes in the group with the two separate procedures because we could adjust the IOL power prior to phaco, the outcomes were very similar,” Sánchez Ventosa said.
The phaco-DMEK group achieved corrected distance visual acuity of 0.82 logMAR vs. 0.94 logMAR in the other group, and no statistically significant difference was found in sphere and cylinder.
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Sánchez Ventosa A, et al. Outcomes in phaco-DMEK versus DMEK and phaco in 2-times with premium IOL. Presented at: European Society of Cataract and Refractive Surgeons winter meeting; March 10-12, 2023; Vilamoura, Portugal.
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