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David Davis-Boozer, Mark Terry, Michael Straiko, Julia Talajic, Asem Alqudah, Mark Greiner; DSAEK & DMEK Triples: How close are we to achieving emmetropia?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3081.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate refractive error after combined Descemet stripping automated endothelial keratoplasty (DSAEK) or Descemet membrane endothelial keratoplasty (DMEK) coupled with cataract surgery and to determine whether the intended target refraction was achieved.
117 eyes with Fuchs’ endothelial dystrophy and cataract underwent combined DSAEK (n=88) or DMEK (n=29) with cataract extraction and IOL implantation. All eyes were targeted for emmetropia by choosing a lens power from IOL Master that provided a refraction of -1.25 to -1.5 D for DSAEK and -0.3 to -0.6 D for DMEK. Postoperative best spectacle-corrected visual acuity (BSCVA) and spherical equivalent (SE) were measured pre- and 1-6 months post-transplant. The difference in actual versus targeted SE was calculated.
After DSAEK, mean BSCVA was 20/26 (range 20/20-20/70), and the mean SE was -0.44 D (range: -3.125 D to +1.625 D). After DMEK, mean BSCVA was 20/26 (range 20/20-20/50), and mean SE was -0.37 D (range: -2.50 D to +2.125 D). Mean postoperative SE was not significantly different between DMEK and DSAEK (p=0.691).
In both DSAEK and DMEK, mean postoperative refraction outcome was very close to our goal. However, there is a wide range of refractive outcomes with both procedures. DMEK appears to have slightly more reliable results, though our sample size is small at this point. These results suggest the need for further study of the hyperopic shift and IOL selection in this population.
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