Visual Recovery After Descemet Membrane Endothelial Keratoplasty in Eyes With Preexisting Multifocal Intraocular Lens.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-03-26 DOI:10.1097/ICO.0000000000003864

Pratima Vishwakarma, Björn Bachmann, Mert Mestanoglu, Silvia Schrittenlocher, Johanna Wiedemann, Simona L Schlereth, Claus Cursiefen

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Abstract

Purpose: To assess visual acuity outcomes in pseudophakic eyes with a multifocal (MF)-IOL (intraocular lens) and endothelial failure receiving Descemet membrane endothelial keratoplasty (DMEK).

Method: This is a retrospective case-series analyzing patients from the prospective Cologne DMEK database where visual acuity outcome in 14 eyes of 9 patients requiring DMEK after MF-IOL implantation was compared with 14 eyes of 14 age-matched controls for DMEK after monofocal IOL implantation. All patients suffered from Fuchs endothelial corneal dystrophy.

Results: The average age at presentation was 69 ± 8.9 and 68 ± 7.6 years for cases and control group, respectively. Average pretransplant best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution was 0.45 ± 0.32 and 0.39 ± 0.19 among cases and control groups, respectively. After exclusion of 4 eyes with other visual acuity limitations and their age-matched control eyes, final average BCVA at follow-up among cases was 0.1 ± 0.07 at 3 months and 0.15 ± 0.10 at 6 months, whereas it was 0.14 ± 0.10 at 3 months (P = 0.435) and 0.05 ± 0.05 at 6 months (P = 0.054) of follow-up among the control group. When including eyes with IOL calcification, BCVA at 1 and 2 years in cases was significantly worse compared with controls. IOL calcification was more common in eyes with preexisting MF-IOL (3/14).

Conclusions: Good visual outcomes can be achieved in eyes where DMEK is done after MF-IOL implantation. Visual acuity recovery may be slower and slightly lesser compared with eyes with preexisting monofocal IOL in situ. The risk of IOL calcification seems higher in MF-IOLs.

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已有多焦人工晶状体的眼视网膜内皮角膜移植术后视力恢复。

目的：评价多焦(MF)-IOL（人工晶状体）和内皮衰竭的假晶状眼接受Descemet膜内皮角膜移植术（DMEK）的视力结果。方法：回顾性分析来自前瞻性科隆DMEK数据库的患者，将9例需要DMEK的患者中14只眼的视力结果与14例年龄匹配的对照组中14只眼的视力结果进行比较。所有患者均患有富氏角膜内皮营养不良。结果：病例和对照组的平均发病年龄分别为69±8.9岁和68±7.6岁。移植前最佳矫正视力（BCVA）的最小分辨角对数分别为0.45±0.32和0.39±0.19。在排除4只其他视力限制的眼及其年龄匹配的对照眼后，患者随访时的最终平均BCVA在3个月时为0.1±0.07，在6个月时为0.15±0.10，对照组随访3个月时为0.14±0.10 (P = 0.435)， 6个月时为0.05±0.05 （P = 0.054）。当纳入IOL钙化眼时，病例1年和2年的BCVA明显差于对照组。人工晶状体钙化在已有MF-IOL的眼睛中更为常见（3/14）。结论：人工晶状体植入术后行DMEK可获得良好的视力效果。视力恢复可能比原位单焦点人工晶状体的眼睛更慢。人工晶状体钙化的风险似乎更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.