Universität zu Köln

Zwingelberg, Sarah B., Buescher, Frederike, Schrittenlocher, Silvia ORCID: 0000-0001-6090-6777, Rokohl, Alexander C., Loreck, Niklas, Wawer-Matos, Philomena, Fassin, Anne, Schaub, Friederike, Roters, Sigrid, Matthaei, Mario, Heindl, Ludwig M., Bachmann, Bjorn O. and Cursiefen, Claus (2022). Long-Term Outcome of Descemet Membrane Endothelial Keratoplasty in Eyes With Fuchs Endothelial Corneal Dystrophy Versus Pseudophakic Bullous Keratopathy. Cornea, 41 (3). S. 304 - 310. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose: The aim of this study was to compare the long-term outcome of Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). Methods: Records of consecutive DMEK surgeries performed between 2015 and 2016 at the Department of Ophthalmology, Cologne, Germany, were retrospectively reviewed from the prospective Cologne DMEK Database. Eyes with either PBK or FECD with a complete 3-year follow-up were enrolled. Main outcome parameters included central corneal thickness (CCT), peripheral corneal thickness (PCT), best spectacle-corrected visual acuity (BSCVA, logarithm of the Minimum Angle of Resolution), and endothelial cell count (ECC) before and after DMEK. Results: Four hundred two eyes from 402 patients were included (FECD n = 371, PBK n = 31). Preoperatively, CCT (FECD: 681.91 +/- 146.78 mu m; PBK: 932.25 +/- 319.84 mu m) and PCT (FECD: 732.26 +/- 98.22 mu m; PBK: 867.54 +/- 88.72 mu m) were significantly higher in the PBK group (P < 0.01). Three years after DMEK, CCT (FECD: 526.56 +/- 27.94 mu m; PBK 663.71 +/- 132.36 mu m) was significantly lower in both groups compared with the preoperative values (P < 0.01), whereas PCT showed no significant difference. PCT increased during the course in the PBK group from month 12 after DMEK (12 mo: 783.73 +/- 127.73 mu m; 24 mo: 837.50 +/- 110.19 mu m; 36 mo: 857.79 +/- 140.76 mu m). The increase in PCT correlated with an accelerated ECC loss starting 12 months after DMEK (P = 0.036). Before DMEK, BSCVA in FECD was significantly higher (P < 0.001) compared with that in PBK. After 3 years, BSCVA improved in FECD and PBK eyes without significant difference (P = 0.239). Conclusions: Visual acuity after DMEK in PBK and FECD seems to be comparable during the long-term follow-up. Peripheral and central corneal edema seems to recur faster in eyes with PBK than in those with FECD. Therefore, using a donor graft with higher ECC or possibly a larger graft could be a promising approach for PBK patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zwingelberg, Sarah B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buescher, Frederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrittenlocher, Silvia UNSPECIFIED orcid.org/0000-0001-6090-6777 UNSPECIFIED Rokohl, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loreck, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wawer-Matos, Philomena UNSPECIFIED UNSPECIFIED UNSPECIFIED Fassin, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaub, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Roters, Sigrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjorn O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-662941
DOI:	10.1097/ICO.0000000000002737
Journal or Publication Title:	Cornea
Volume:	41
Number:	3
Page Range:	S. 304 - 310
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MIGRATION Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66294