Abstract
Purpose :
To assess the efficacy and outcomes of Descemet membrane endothelial keratoplasty (DMEK) operated with a standard operating microscope (SOM) and a three-dimensional heads-up display (3D HUD).
Methods :
Eighty-six eyes of 86 patients with corneal decompensation due to fuchs endothelial dystrophy (FED) or pseudophakic bullous keratopathy (PBK). All eyes underwent Descemet membrane endothelial keratoplasty (DMEK) using either a 3D HUD (NGENUITY; Alcon Inc., Fort Worth, Texas, USA; n=39 eyes) or a SOM setting (n=47 eyes); in cases of significant cataract, additional phacoemulsification with intraocular lens (IOL) implantation was performed. Minimum follow-up was three months.
Results :
There were 39 eyes in the 3D HUD and 47 eyes in the SOM group. In general, the 3D HUD group was slightly younger than the SOM group (72.64±8.34 vs. 76.51±11.76, p=0.02). Both groups did not differ concerning their indication for DMEK (FED vs. PBK, p=0.83), other visual acuity limiting diseases (p=0.64), past keratoplasty procedure (p=0.37) and preoperative BCVA (p=0.09). Postoperatively, 3D HUD and SOM were comparable concerning the duration of surgery (3D HUD: 34.85±21.22 min; SOM: 41.21±24.38 min; p=0.09), the rate of surgical re-bubbling (17.9 % vs. 25.5 %; p=0.45), rate of graft rejection (5.1 % vs. 21.3 %) and final BCVA (0.30±0.34 vs. 0.35±0.34 logMAR; p=0.19).
Conclusions :
On par results to a conventional operating microscope can be achieved with a 3D HUD setting when performing Descemet membrane endothelial keratoplasty including the duration of surgery, postoperative complications such as graft rejection and final BCVA.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.