Abstract
Purpose :
To analyze the effect of intensified topical steroid therapy after Descemet’s Membrane Endothelial Keratoplasty combined with cataract surgery (Triple-DMEK) on the incidence of postoperative cystoid macular edema (CME).
Methods :
Design: Single center comparative clinical study with historical controls.
<span style="line-height:1.6">Setting: Department of Ophthalmology, University of Cologne, Germany, tertiary hospital, performing 500 corneal transplant surgeries per year.</span>
Patients: 150 eyes of 131 patients undergoing Triple-DMEK surgery. Inclusion criterion: Triple-DMEK surgery. Exclusion criteria: Prior retinal surgery, history of prior CME.
Interventions: Prednisolone acetate eye drops 1% 5 times daily for the first week after surgery. After an internal change of therapy regimen: Prednisolone acetate eye drops 1% hourly for the first postoperative week. We compared 75 consecutive eyes before with 75 consecutive eyes after the change of therapy regimen. Patients received macular spectral domain optical coherence tomography (SD-OCT) preoperatively, as well as 6 weeks, 3 and 6 months post surgery.
Main Outcome Measure: Development of CME detected by macular SD-OCT during 6 months postoperatively.
Results :
Both groups were comparable regarding baseline age, gender, central corneal thickness, rebubbling rate and visual acuity. With topical steroid therapy 5 times per day during the first postoperative week, we observed 9 cases of subsequent CME (12%). With hourly topical steroid therapy none of the patients developed CME subsequently (P=0.003). Apart from the topical steroids during first week, medical treatment was identical in both groups.
Conclusions :
Early intensified postoperative topical steroid therapy constitutes an effective prophylactic treatment to reduce incidence of CME after Triple-DMEK surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.