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. 2022 May 12;17(5):e0267940.
doi: 10.1371/journal.pone.0267940. eCollection 2022.

Comparison of triple-DMEK to pseudophakic-DMEK: A cohort study of 95 eyes

Axelle Semler-Collery  1 , Florian Bloch  1 , George Hayek  1 , Christophe Goetz  2 , Jean Marc Perone  1   3
Affiliations

Comparison of triple-DMEK to pseudophakic-DMEK: A cohort study of 95 eyes

Axelle Semler-Collery et al. PLoS One. .

Abstract

Previous comparative studies show that triple Descemet membrane endothelial keratoplasty (DMEK) (i.e. phacoemulsification followed immediately by DMEK) has either equivalent or better visual outcomes than DMEK in pseudophakic patients. To resolve this discrepancy, a retrospective cohort study was conducted. All consecutive patients with Fuchs Endothelial Corneal Dystrophy who underwent triple or pseudophakic DMEK in 2015-2019 in a tertiary-care hospital (France) and were followed for >12 months were compared in terms of best spectacle-corrected visual acuity (BSCVA), final refractive outcomes, and endothelial-cell loss at 12 months as well as rebubbling rates. The triple-DMEK (40 eyes, 34 patients) and pseudophakic-DMEK (55 eyes, 43 patients) groups were similar in terms of age and other baseline variables. They also did not differ in final BSCVA (both 0.03 logMAR), final endothelial-cell loss (54% vs. 48%), or astigmatism (-1.25 vs. -1 D). At 12 months, triple-DMEK associated with significantly smaller residual hyperopia (0.75 vs. 1 D; p = 0.04) and spherical equivalence (0 vs. 0.5 D; p = 0.02). Triple-DMEK also tended to associate with more frequent rebubbling (40% vs. 24%, p = 0.09). In conclusion, while triple-DMEK and pseudophakic-DMEK achieved similar visual acuity improvement, triple-DMEK was superior in terms of final sphere and spherical refraction but also tended to have higher complication rates.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart depicting the disposition of the subjects during the study.
AMD, age-related macular degeneration; DMEK, Descemet membrane endothelial keratoplasty.
Fig 2
Fig 2. Change in visual acuity during follow-up.
DMEK, Descemet membrane endothelial keratoplasty.
Fig 3
Fig 3. Change in central corneal thickness in the study groups.
DMEK, Descemet membrane endothelial keratoplasty.
Fig 4
Fig 4. Frequency of one or two rebubbling sessions after surgery.
DMEK, Descemet membrane endothelial keratoplasty.
See this image and copyright information in PMC

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