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Updated: Mar 27, 2026
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Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
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[Refractive changes in triple Descemet membrane endothelial keratoplasty]
C Girbardt1, N Oertel2, J Adamek-Dyk2
1Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig, Liebigstraße 10-14, 04103, Leipzig, Deutschland. christian.girbardt@medizin.uni-leipzig.de.
Summary
Triple Descemet membrane endothelial keratoplasty (DMEK) surgery causes a hyperopic shift in vision due to changes in corneal shape. This necessitates selecting stronger myopic intraocular lens targets for better refractive outcomes.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- A hyperopic shift is a known complication of Descemet membrane endothelial keratoplasty (DMEK).
- This refractive shift is particularly important in triple DMEK, a combined procedure with cataract surgery, impacting intraocular lens power selection.
Purpose of the Study:
- To evaluate the refractive changes after triple DMEK.
- To classify the mechanisms causing these refractive changes using corneal topographical data.
Main Methods:
- Retrospective analysis of 29 eyes from 26 patients undergoing triple DMEK.
- Comparison of preoperative and postoperative refractions against target refractions.
- Calculation of refractive power using corneal topography and the Gullstrand formula.
Main Results:
- A mean hyperopic shift was observed post-procedure.
- Triple DMEK caused posterior corneal steepening and anterior corneal flattening, reducing overall refractive power.
- Posterior corneal surface changes were the primary driver of the refractive shift.
Conclusions:
- The hyperopic shift is a mean outcome, and individual prediction remains challenging.
- Intraocular lens selection should target stronger myopic refractions than typically used in standard cataract surgery.
