Rapid sequential endothelial keratoplasty with and without combined cataract extraction

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Restoration

Background:

• Fuchs endothelial corneal dystrophy causes progressive visual impairment.
• Descemet membrane endothelial keratoplasty (DMEK) is an advanced endothelial keratoplasty technique.
• Sequential bilateral DMEK offers a potential solution for patients with bilateral visual loss.

Purpose of the Study:

• To evaluate the outcomes of sequential bilateral Descemet membrane endothelial keratoplasty (DMEK) combined with cataract extraction.
• To assess the efficacy of performing DMEK on both eyes within a 1- to 2-week timeframe for Fuchs dystrophy.

Main Methods:

• Retrospective case series of 12 patients undergoing bilateral DMEK within 2 weeks.
• Included both triple procedures (cataract extraction and DMEK) and DMEK alone.
• Analyzed corrected distance visual acuity (CDVA) and graft outcomes.

Main Results:

• Median CDVA improved from 20/40 preoperatively to 20/20 by 3-6 months postoperatively.
• All grafts successfully attached and cleared, with a low rate of air reinjection for partial detachment.
• No significant difference in air reinjection rates between triple and single procedures.

Conclusions:

• Sequential bilateral DMEK within 1-2 weeks is a viable treatment for Fuchs dystrophy.
• DMEK provides rapid visual recovery, comparable to cataract surgery.
• Corneal transplantation outcomes are approaching those of cataract surgery in terms of recovery speed.