Retinal Detachment Rates After Uncomplicated DMEK Versus Cataract Surgery Combined (Triple-)DMEK

Verena Schöneberger; Volkan Tahmaz; Leonie Menghesha; Jan Niklas Lüke; Claus Cursiefen; Friederike Schaub; Björn O Bachmann

doi:10.1097/ICO.0000000000003554

Retinal Detachment Rates After Uncomplicated DMEK Versus Cataract Surgery Combined (Triple-)DMEK

Cornea. 2024 Apr 25. doi: 10.1097/ICO.0000000000003554. Online ahead of print.

Authors

Verena Schöneberger¹, Volkan Tahmaz¹, Leonie Menghesha¹, Jan Niklas Lüke¹, Claus Cursiefen¹, Friederike Schaub^{1

2}, Björn O Bachmann¹

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and.
² Department of Ophthalmology, University Medical Center Rostock, University of Rostock, Rostock, Germany.

PMID: 38692685
DOI: 10.1097/ICO.0000000000003554

Abstract

Purpose: To evaluate the rate of and risk factors for rhegmatogenous retinal detachment (RRD) after Descemet membrane endothelial keratoplasty (DMEK) either alone or in combination with cataract surgery.

Design: Retrospective analysis of prospective database.

Methods: Consecutive eyes with Fuchs endothelial corneal dystrophy (FECD) that received DMEK surgery with a minimum follow-up of 1 year between July 2011 and January 2021 at the Department of Ophthalmology at the University of Cologne were analyzed. Exclusion criteria were complicated history including repeat DMEK within 1-year, previous retinal or glaucoma surgery, complicated phacoemulsification, congenital cataract, history of trauma.

Results: From 3858 consecutive DMEKs, 1961 patients were identified suitable for analysis. 846 (43.1%) were pseudophakic DMEK, 91 (4.6%) phakic DMEK and 1,024 (52.2%) combined with cataract surgery. RRD occurred in 13 eyes (12 patients). Within two years after DMEK RRD occurred in 0.49% and 0.47% after DMEK and DMEK with cataract surgery, respectively. Mean age of 59.24 ± 8.42 years with subsequent RRD was significantly lower than overall 68.81 ± 9.89 years (t-test two-tailed; p < 0.001). The spherical equivalent was -4.69 ± 3.98 D (range -9.00 to 0.5) in RRD after pseudophakic DMEK compared to -2.79 ± 3.54 D (range -7.5 to 0.75) in combined procedures. Re-bubbling had no influence on RRD rate.

Conclusions: DMEK alone or in combination with cataract surgery showed similar postoperative RRD rates in the first two years, generally in the range of pseudophakic RRDs. Risk factors such as myopia and younger age could be identified. Re-bubbling has no influence on RRD rates.