Universität zu Köln

Hoerster, Robert, Stanzel, Tisha P., Bachmann, Bjoern O., Siebelmann, Sebastian and Cursiefen, Claus (2016). Intensified Early Postoperative Topical Steroids Do Not Influence Endothelial Cell Density After Descemet Membrane Endothelial Keratoplasty Combined With Cataract Surgery (Triple-DMEK). Cornea, 35 (11). S. 1396 - 1401. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose:To investigate the effect of intensified postoperative topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (Triple-DMEK) on postoperative endothelial cell density (ECD).Methods:This comparative clinical study with historical controls was conducted at a tertiary hospital, specialized in corneal surgery. Patients undergoing DMEK or Triple-DMEK are included prospectively in the Cologne DMEK Database. Until April 2014, first week's postoperative standard therapy for lamellar keratoplasties was prednisolone acetate eye drops 1% applied 5x daily. After April 2014, first week's postoperative standard therapy changed to prednisolone acetate eye drops 1% applied hourly. We compared 75 consecutive eyes before (group 1) with 75 consecutive eyes after the change of therapy regimen (group 2). Patients received ECD analysis 3 and 6 months after surgery.Results:ECD of grafts in group 1 before transplantation, and 3 months and 6 months after surgery was 2697 218, 1765 +/- 349, and 1703 +/- 432 cells/mm(2), respectively. ECD of grafts in group 2 was 2696 +/- 267, 1737 +/- 450, and 1694 +/- 482 cells/mm(2), respectively. Over 3 and 6 months, ECD in group 1 decreased by 35% +/- 13% and 38% +/- 18%, respectively. In group 2, ECD decreased by 36% +/- 16% and 38% +/- 16%, respectively. Neither absolute numbers nor decrease in ECD differed significantly between groups 1 and 2 at any time point (all P > 0.60).Conclusions:Intensified early postoperative topical steroid therapy during the first postoperative week does not stabilize ECD, nor does it have a toxic effect on endothelial cells during a follow-up of 6 months.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoerster, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Stanzel, Tisha P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-257252
DOI:	10.1097/ICO.0000000000000981
Journal or Publication Title:	Cornea
Volume:	35
Number:	11
Page Range:	S. 1396 - 1401
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREDNISOLONE ACETATE 1-PERCENT; SPLIT CORNEA TRANSPLANTATION; CYSTOID MACULAR EDEMA; RISK; EYES Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25725