Universität zu Köln

Hoerster, Robert, Stanzel, Tisha Prabriputaloong, Bachmann, Bjoern Olov, Siebelmann, Sebastian, Felsch, Moritz and Cursiefen, Claus (2016). Intensified Topical Steroids as Prophylaxis for Macular Edema After Posterior Lamellar Keratoplasty Combined With Cataract Surgery. Am. J. Ophthalmol., 163. S. 174 - 180. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1879-1891

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Abstract

PURPOSE: To analyze the effect of intensified topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple-DMEK) on the incidence of postoperative cystoid macular edema (CME). DESIGN: Single-center comparative clinical study with historical controls. METHODS: SETTING: Department of Ophthalmology, University of Cologne, Germany, tertiary hospital, performing 500 corneal transplant surgeries per year. PATIENTS: Total of 131 patients (150 eyes) undergoing triple-DMEK surgery. INCLUSION CRITERION: Triple-DMEK surgery. EXCLUSION CRITERIA: Prior retinal surgery, history of prior CME. INTERVENTIONS: Prednisolone acetate eye drops 1% 5 times daily for the first week after surgery. After an internal change of therapy regimen: Prednisolone acetate eye drops 1% hourly for the first postoperative week. We compared 75 consecutive eyes before with 75 consecutive eyes after the change of therapy regimen. Patients received macular spectral domain optical coherence tomography (SD OCT) preoperatively, as well as 6 weeks and 3 and 6 months post surgery. MAIN OUTCOME MEASURE: Development of CME detected by macular SD OCT during 6 months postoperatively. RESULTS: Both groups were comparable regarding baseline age, sex, central corneal thickness, rebubbling rate, and visual acuity. With topical steroid therapy 5 times per day during the first postoperative week, we observed 9 cases of subsequent CME (12%). With hourly topical steroid therapy none of the patients developed CME subsequently (P=.003). Apart from the topical steroids during the first week, medical treatment was identical in both groups. CONCLUSIONS: Early intensified postoperative topical steroid therapy constitutes an effective prophylactic treatment to reduce incidence of CME after triple-DMEK surgery. (C) 2016 by Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoerster, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Stanzel, Tisha Prabriputaloong UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern Olov UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Felsch, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-283171
DOI:	10.1016/j.ajo.2015.12.008
Journal or Publication Title:	Am. J. Ophthalmol.
Volume:	163
Page Range:	S. 174 - 180
Date:	2016
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1879-1891
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEMBRANE ENDOTHELIAL KERATOPLASTY; COMPLICATIONS; BARRIER Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28317