Tomographic Differences in Thin Corneas Following DMEK in Fuchs Dystrophy: A Case-Control Study.
Josep Torras-Sanvicens1,2, Marc Figueras-Roca3, Carlos Rocha-de-Losada3,4,5,6,7
1Hospital Clínic Barcelona (ICOF), Universitat de Barcelona, Travessera de Dalt, 66-68, 5-1B, 08024, Barcelona, Spain. jts29206@gmail.com.
Ophthalmology and Therapy
|November 8, 2025
Summary
Patients with Fuchs endothelial corneal dystrophy undergoing Descemet membrane endothelial keratoplasty often experience corneal thinning, especially women. This suggests preoperative corneal edema may influence stromal remodeling after the procedure.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Corneal Imaging
Background:
- Fuchs endothelial corneal dystrophy (FECD) is a progressive condition affecting the cornea's inner lining.
- Descemet membrane endothelial keratoplasty (DMEK) is a surgical option for FECD, aiming to restore corneal clarity.
- Understanding post-DMEK corneal changes is crucial for patient outcomes.
Purpose of the Study:
- To investigate the prevalence of thin corneas after DMEK in FECD patients.
- To identify tomographic patterns associated with corneal thickness post-DMEK.
- To explore factors influencing corneal thickness changes following DMEK.
Main Methods:
- Retrospective observational study of 88 eyes with FECD treated with DMEK.
- Comparison with an age- and sex-matched control group.
- Analysis of central corneal thickness (CCT) and pachymetric indices using Scheimpflug imaging (Pentacam HR).
Main Results:
- DMEK patients had significantly thinner corneas (mean CCT 525 µm) at 1 year compared to controls (561 µm).
- Women were more prone to thin corneas (<500 µm) and had higher Belin-Ambrosio D index values.
- Preoperative CCT, age, and sex predicted greater pachymetric reduction, with thicker preoperative corneas, older age, and female sex leading to thinner 1-year CCT.
Conclusions:
- Corneal thinning is common after DMEK in FECD patients, particularly in women.
- Chronic preoperative corneal edema may be linked to stromal remodeling post-DMEK.
- Further research is needed to understand the mechanisms behind this postoperative thinning.
