Outcomes of cystoid macular edema following Descemet's membrane endothelial keratoplasty in a referral center for keratoplasty in Spain : retrospective study
Moura-Coelho, Nuno (Hospital CUF Cascais)
Papa-Vettorazzi, Renato (Instituto Microcirurgia Ocular)
Santiesteban-García, Imalvet (Instituto Microcirurgia Ocular)
Dias-Santos, Arnaldo (Centro Hospitalar Universitário Lisboa Central)
Manero, Felicidad (Universitat Autònoma de Barcelona)
Cunha, João Paulo (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:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
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

9 p, 1.1 MB

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