Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review
Abstract Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in FECD patients are not as favorable as those in eyes without this condition. Historically, only monofocal intraocular lens...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-023-03240-5 |
| _version_ | 1797453492978188288 |
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| author | Marina Rodríguez-Calvo-de-Mora Carlos Rocha-de-Lossada Vito Romano Manuel Rodríguez-Vallejo Joaquín Fernández |
| author_facet | Marina Rodríguez-Calvo-de-Mora Carlos Rocha-de-Lossada Vito Romano Manuel Rodríguez-Vallejo Joaquín Fernández |
| author_sort | Marina Rodríguez-Calvo-de-Mora |
| collection | DOAJ |
| description | Abstract Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in FECD patients are not as favorable as those in eyes without this condition. Historically, only monofocal intraocular lenses (IOLs) were recommended for these patients. However, recent reports have described the implantation of Premium-IOLs (such as Multifocal IOLs, Enhanced Depth of Focus IOLs, and Toric IOLs) in FECD eyes undergoing cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). While the results are encouraging, they are not as optimal as those from unoperated eyes, especially when comparing simultaneous procedures to sequential ones. It’s advised to perform the DMEK first to improve the accuracy of IOL calculations. Still, even successfully operated eyes may experience secondary graft failure or graft rejection after DMEK. The success rate of a secondary DMEK is typically lower than that of the initial procedure. Furthermore, if the postoperative thickness after DMEK is less than anticipated, laser enhancements might not be an option. There’s a pressing need for more controlled and randomized clinical trials to ascertain the safety and effectiveness of Premium-IOLs for FECD eyes. This narrative review aims to collate evidence on the use of Premium IOL technologies in eyes receiving EK and to underscore key points for surgeons performing EK combined with cataract surgery. |
| first_indexed | 2024-03-09T15:23:38Z |
| format | Article |
| id | doaj.art-a87a4f8fd6424da4b85ed21393c32d3a |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-09T15:23:38Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-a87a4f8fd6424da4b85ed21393c32d3a2023-11-26T12:40:04ZengBMCBMC Ophthalmology1471-24152023-11-0123111110.1186/s12886-023-03240-5Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative reviewMarina Rodríguez-Calvo-de-Mora0Carlos Rocha-de-Lossada1Vito Romano2Manuel Rodríguez-Vallejo3Joaquín Fernández4Qvision, Department of Ophthalmology of VITHAS Almería HospitalQvision, Department of Ophthalmology of VITHAS Almería HospitalOphthalmic Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of BresciaQvision, Department of Ophthalmology of VITHAS Almería HospitalQvision, Department of Ophthalmology of VITHAS Almería HospitalAbstract Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in FECD patients are not as favorable as those in eyes without this condition. Historically, only monofocal intraocular lenses (IOLs) were recommended for these patients. However, recent reports have described the implantation of Premium-IOLs (such as Multifocal IOLs, Enhanced Depth of Focus IOLs, and Toric IOLs) in FECD eyes undergoing cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). While the results are encouraging, they are not as optimal as those from unoperated eyes, especially when comparing simultaneous procedures to sequential ones. It’s advised to perform the DMEK first to improve the accuracy of IOL calculations. Still, even successfully operated eyes may experience secondary graft failure or graft rejection after DMEK. The success rate of a secondary DMEK is typically lower than that of the initial procedure. Furthermore, if the postoperative thickness after DMEK is less than anticipated, laser enhancements might not be an option. There’s a pressing need for more controlled and randomized clinical trials to ascertain the safety and effectiveness of Premium-IOLs for FECD eyes. This narrative review aims to collate evidence on the use of Premium IOL technologies in eyes receiving EK and to underscore key points for surgeons performing EK combined with cataract surgery.https://doi.org/10.1186/s12886-023-03240-5Endothelial keratoplastyDescemet membrane endothelial keratoplastyMultifocal intraocular lensesExtended-depth of focus intraocular lensesToric intraocular lensesPresbyopia‐correcting intraocular lenses |
| spellingShingle | Marina Rodríguez-Calvo-de-Mora Carlos Rocha-de-Lossada Vito Romano Manuel Rodríguez-Vallejo Joaquín Fernández Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review BMC Ophthalmology Endothelial keratoplasty Descemet membrane endothelial keratoplasty Multifocal intraocular lenses Extended-depth of focus intraocular lenses Toric intraocular lenses Presbyopia‐correcting intraocular lenses |
| title | Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review |
| title_full | Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review |
| title_fullStr | Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review |
| title_full_unstemmed | Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review |
| title_short | Descemet membrane endothelial keratoplasty combined with presbyopia‐correcting and toric intraocular lenses – a narrative review |
| title_sort | descemet membrane endothelial keratoplasty combined with presbyopia correcting and toric intraocular lenses a narrative review |
| topic | Endothelial keratoplasty Descemet membrane endothelial keratoplasty Multifocal intraocular lenses Extended-depth of focus intraocular lenses Toric intraocular lenses Presbyopia‐correcting intraocular lenses |
| url | https://doi.org/10.1186/s12886-023-03240-5 |
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