1. Comparison of Mini-DMEK versus predescemetal sutures as treatment of acute hydrops in keratoconus
- Author
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Ferdi Ögrünc, Deniz Hos, Alexander Händel, Björn Bachmann, Claus Cursiefen, Sebastian Siebelmann, and Mario Matthaei
- Subjects
Corneal hydrops ,Adult ,Male ,medicine.medical_specialty ,Keratoconus ,Visual acuity ,genetic structures ,Visual Acuity ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Surgical treatment ,Descemet Membrane ,Acute hydrops ,Retrospective Studies ,Best corrected visual acuity ,Sutures ,business.industry ,Corneal Edema ,Suture Techniques ,General Medicine ,Middle Aged ,medicine.disease ,eye diseases ,Treatment Outcome ,Acute Disease ,030221 ophthalmology & optometry ,Tears ,Female ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Descemet Stripping Endothelial Keratoplasty ,Tomography, Optical Coherence - Abstract
Purpose To compare two surgical treatment options for acute corneal hydrops in keratoconus: Mini-DMEK versus predescemetal sutures. Methods Sixteen patients were treated by either Mini-Descemet membrane endothelial keratoplasty (Mini-DMEK) (n = 7, group 1) or predescemetal sutures (n = 9, group 2) early after onset of acute hydrops. Visual acuity, maximum corneal thickness (SD-OCT) in the affected oedematous area, complications and recurrence rates were retrospectively compared between both groups. Measurements were taken immediately preoperatively as well as 1 day, 1 week and 1 month postoperatively (Table 1). Results Both groups showed reductions in corneal thickness and increased visual acuity shortly after surgery. In group 1 (average age 33 years ± 7 years), the best corrected visual acuity (BCVA) increased from logMAR 1.65 ± 0.7 before Mini-DMEK to logMAR 0.93 ± 0.6 30 days after Mini-DMEK (p = 0.046). During that period, maximum corneal thickness decreased from 1159 ± 338 µm before surgery to 531 ± 75 µm after Mini-DMEK (p = 0.046). Patients from group 2 (average age 34 ± 10 years) had a BCVA of logMAR 1.59 ± 0.8 which increased to logMAR 0.97 ± 0.5 (p = 0.014) 30 days after surgery. At the same time, the preoperative maximum corneal thickness decreased from 1439 ± 272 µm to 476 ± 162 µm (p = 0.014). There was no difference in corneal thickness or BCVA one month after the surgical intervention between both groups (p = 0.394 and p = 0.871). Conclusions Both techniques, Mini-DMEK and predescemetal sutures, are effective in the treatment of an acute hydrops in keratoconus. Mini-DMEK appears to be beneficial in large DM tears.
- Published
- 2021