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Satoru Inoda, Takahiko Hayashi, Hidenori Takahashi, Itaru Oyakawa, Hideaki Yokogawa, Akira Kobayashi, Naoko Kato, Hidetoshi Kawashima; Cystoid macular edema following staged Descemet’s Membrane Endothelial Keratoplasty in Asian Eyes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6288.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of the current study was to investigate the factors associated with the occurrence of cystoid macular edema (CME) following Descemet’s membrane endothelial keratoplasty (DMEK) in Asian eyes.
This retrospective multicenter study included 53 eyes of 42 patients with corneal endothelial dysfunction who underwent DMEK 1 month after phacoemulsification and intraocular lens (IOL) implantation surgery between 2015 and 2017 in Japan. The evaluated parameters included the postoperative (1, 3, and 6 months after surgery) best spectacle-corrected visual acuity [BSCVA; logarithm of the minimum angle of resolution (logMAR)], central corneal thickness (CCT), corneal endothelial cell density (ECD), and central retinal thickness (CRT) measured by optical coherence tomography (OCT), as well as the air volume in the anterior chamber (AC) and axial length (AXL) on postoperative day 1. Putative factors associated with the incidence of CME after DMEK were statistically analyzed with these parameters, in addition to pre-existing iris damage scores, age, sex, the preoperative visual acuity (Pre-VA), the rate of rebubbling, a past history of diabetes, and the ECD loss rate at 6 months after surgery.
Within 6 months after DMEK, CME occurred in six of the 53 (11.3%) eyes. Although BSCVA significantly improved from 0.78 before surgery to 0.053 at 6 months after surgery (p < 0.001), there was no significant difference between eyes with CME and those without CME (p = 0.67). Multivariable analysis revealed that iris damage (CME, p < 0.0001; CRT, p = 0.0062) and age (CME, p < 0.0001; CRT, p = 0.023) were significantly associated with CME occurrence and higher CRT. Stepwise variable selection showed that only iris damage (p < 0.0001) was the most important risk factor for higher CRT as well as the occurrence of CME.
Our findings suggest that the incidence of CME after DMEK for Asian patients is similar to that reported for patients from the West. Iris damage may be strongly associated with the occurrence and progression of CME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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