Cystoid macular oedema following Descemet membrane endothelial keratoplasty.

Autor:	Heinzelmann S; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany., Maier P; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany., Böhringer D; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany., Hüther S; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany., Eberwein P; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany., Reinhard T; Eye Center, Albert Ludwigs University of Freiburg, Freiburg, Germany.
Jazyk:	angličtina
Zdroj:	The British journal of ophthalmology [Br J Ophthalmol] 2015 Jan; Vol. 99 (1), pp. 98-102. Date of Electronic Publication: 2014 Aug 19.
DOI:	10.1136/bjophthalmol-2014-305124
Abstrakt:	Background: To determine the incidence and potential risk factors of cystoid macular oedema (CMO) following Descemet membrane endothelial keratoplasty (DMEK) with or without simultaneous cataract surgery. Methods: In this study, 155 eyes of 88 patients suffering from Fuchs endothelial dystrophy (81%), bullous keratopathy (17.6%) or other corneal diseases (1.4%) underwent DMEK. 52% were pseudophacic (DMEK) and 48% received simultaneous cataract surgery (DMEK combined with cataract surgery (Triple-DMEK)) at the Eye Center at Albert Ludwigs University of Freiburg between May 2011 and June 2013. Spectral-domain optical coherence tomography (SD-OCT) was performed 6 weeks, 3 months and 6 months following (Triple-)DMEK and in unscheduled visits due to limited or decreased visual acuity. The medical records were reviewed for pre-existing comorbidities limiting visual acuity. Patients with a history of macular oedema were excluded. We estimated the incidence of CMO using the Kaplan-Meier method. Potential risk factors for CMO were analysed with a Cox regression analysis and Pearson's correlation. The Cox model included the following variables: patient age and axial length, simultaneous cataract surgery, rate of rebubbling, donor age and donor endothelial cell density. Results: 13% of all eyes developed a single episode of CMO at the end of the follow-up. After 6 months, 13.3% of eyes following Triple-DMEK and 12.5% of eyes following DMEK showed CMO. There was a statistically significant correlation between CMO development and best spectacle corrected visual acuity. Long axial length had a protective effect on CMO development (HR=0.3; p=0.03). Under medical therapy, central foveal thickness decreased in all patients. CMO did not have a relevant effect on long-term visual acuity. Conclusions: CMO is a frequent complication following DMEK in phacic and pseudophacic eyes. The prognosis is excellent given medical treatment. We recommend regular SD-OCT monitoring during the first 6 months following DMEK. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
Databáze:	MEDLINE
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