Outcomes of cystoid macular edema following Descemet's membrane endothelial keratoplasty in a referral center for keratoplasty in Spain : retrospective study
Moura-Coelho, Nuno ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital CUF Cascais)
Papa-Vettorazzi, Renato (Instituto Microcirurgia Ocular)
Santiesteban-García, Imalvet (Instituto Microcirurgia Ocular)
Dias-Santos, Arnaldo ![ORCID Identifier](/img/uab/orcid.ico)
(Centro Hospitalar Universitário Lisboa Central)
Manero, Felicidad (Universitat Autònoma de Barcelona)
Cunha, João Paulo ![ORCID Identifier](/img/uab/orcid.ico)
(Escola Superior de Tecnologias da Saúde de Lisboa)
Güell, Jose
(Universitat Autònoma de Barcelona. Departament de Cirurgia)
Date: |
2023 |
Abstract: |
The aim of this study was to analyze the outcomes of eyes with visually significant cystoid macular œdema (vs-CMO) after Descemet membrane endothelial keratoplasty (DMEK) in a referral center for keratoplasty in Spain. We conducted a retrospective, single-surgeon case series of eyes that developed post-DMEK vs-CMO performed between January 2011 and December 2020. Data collected included: indication for DMEK; biometric data; ocular comorbidities; past medical history; time to detection of vs-CMO after DMEK (T, weeks); best-corrected visual acuity (BCVA, logMAR) and central retinal thickness (CRT, µm) at diagnosis of vs-CMO, after resolution of CMO, and at last follow-up; and management strategy. Main outcomes analyzed were incidence of vs-CMO, improvement in BCVA and CRT after treatment of vs-CMO. Of 291 consecutive DMEK surgeries, 14 eyes of 13 patients (4. 8%) developed vs-CMO. Five patients (38. 5%) had history of CMO, and 28. 6% of eyes had ophthalmic comorbidities. Median (P25-P75) T was 4 (3-10) weeks. Treatment success was observed in 12/13 eyes (92. 3%), two of which required second-line treatment. In successful cases (median time-to-resolution 3. 0 (2. 0-3. 5) months), median BCVA improved from 0. 60 (0. 40-0. 80) logMAR to 0. 30 (0. 15-0. 40) logMAR (p = 0. 002) after treatment, and median CRT improved from 582. 5 (400. 0-655. 0) µm to 278. 0 (258. 0-294. 0) µm (p = 0. 005). In our study, we found a 4. 8% rate of post-DMEK vs-CMO, with most cases occurring in the first 3 months after surgery. Good functional and anatomical outcomes are expected in most eyes, without treatment-related complications or implications in graft outcomes. Additional studies are encouraged to determine a standardized protocol for post-DMEK vs-CMO. |
Rights: |
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Language: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Subject: |
Pathogenesis ;
Risk factors ;
Signs and symptoms |
Published in: |
Scientific reports, Vol. 13 (february 2023) , ISSN 2045-2322 |
DOI: 10.1038/s41598-023-29127-5
PMID: 36759529
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Record created 2023-07-28, last modified 2023-08-18