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Malyugin B.E.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Geliastanov A.M.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Antonova O.P.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Andreeva E.A.

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Poletaeva M.V.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Isabekov R.S.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Outcomes of hemi-Descemet membrane endothelial keratoplasty and phacoemulsification for the treatment of primary Fuchs’ endothelial corneal dystrophy combined with cataract

Authors:

Malyugin B.E., Geliastanov A.M., Antonova O.P., Andreeva E.A., Poletaeva M.V., Isabekov R.S.

More about the authors

Journal: Russian Annals of Ophthalmology. 2024;140(1): 36‑44

DOI: 10.17116/oftalma202414001136

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Table of contents

To cite this article:

Malyugin BE, Geliastanov AM, Antonova OP, Andreeva EA, Poletaeva MV, Isabekov RS. Outcomes of hemi-Descemet membrane endothelial keratoplasty and phacoemulsification for the treatment of primary Fuchs’ endothelial corneal dystrophy combined with cataract. Russian Annals of Ophthalmology. 2024;140(1):36‑44. (In Russ.)
https://doi.org/10.17116/oftalma202414001136

Подписка 2025 (Russian Annals of Ophthalmology)
 
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PURPOSE

This study evaluates the long-term results of surgical treatment of patients with Fuchs’ endothelial corneal dystrophy and cataract.

MATERIAL AND METHODS

The study included 24 patients (24 eyes) with primary Fuchs’ endothelial corneal dystrophy and cataract, who underwent cataract phacoemulsification with IOL implantation and of Descemet’s membrane endothelial keratoplasty with a semicircular graft (hemi-DMEK). The effect of treatment was assessed by best corrected visual acuity (BCVA), central corneal thickness (CCT) and endothelial cell density (ECD).

RESULTS

In total, surgical treatment involved 14 donor corneas that were divided in half during the preparation and isolation of the Descemet’s membrane (DM). By month 12 after the surgery an increase in visual functions and graft transparency were observed in 23 patients (23 eyes) out of 24. Repeated keratoplasty was required in one case due to fibrosis of the posterior layers of recipient’s corneal stroma. At 12 months postoperatively, the study group showed an increase in BCVA from 0.16±0.1 to 0.75±20, a decrease in CCT from 650.9±4.5 μm to 519.6±43.9, and a decreased in ECD from 2850.5±84.7 cells/mm2 up to 1285.5±277.2 cells/mm2. Thus, the loss of endothelial cells at one year after surgery amounted to 54.9%.

CONCLUSIONS

The developed method for transplantation of a semicircular DM fragment provides a tissue-saving approach to endothelial keratoplasty, and considering the high percentage of transparent engraftment of grafts and complete visual rehabilitation, it can be recommended in the treatment of patients with cataract and Fuchs’ endothelial corneal dystrophy.

Keywords:

Fuchs’ endothelial corneal dystrophy
endothelial keratoplasty
corneal transplantation
Descemet’s membrane
corneal endothelium
corneal thickness

Authors:

Malyugin B.E.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Geliastanov A.M.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Antonova O.P.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Andreeva E.A.

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Poletaeva M.V.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Isabekov R.S.

S.N. Fedorov National Medical Research Center “MINK “Eye Microsurgery”

Received:

27.03.2022

Accepted:

12.07.2022

List of references:

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  2. Malyugin BE, Antonova OP, Skorodumova LO, Sharova EI, Selezneva OV, Danilenko SA, Kostryukova ES. The study of genetic markers associated with primary endothelial corneal dystrophy (Fuchs). Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirrgia. 2016;(4):44-50. (In Russ.). https://doi.org/10.25276/0235-4160-2016-4-44-50
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  4. Skorodumova LO, Belodedova AV, Antonova OP, et al. CTG18.1 Expansion is the Best Classifier of Late-Onset Fuchs’ Corneal Dystrophy Among 10 Biomarkers in a Cohort From the European Part of Russia. Invest Ophthalmol Vis Sci. 2018;59(11):4748-4754. https://doi.org/10.1167/iovs.18-24590
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  6. Singh R, Gupta N, Vanathi M, Tandon R. Corneal transplantation in the modern era. Indian J Med Res. 2019;150(1):7-22.  https://doi.org/10.4103/ijmr.IJMR_141_19
  7. Malyugin BE, Shilova NF, Antonova OP, Anisimova NS, Shormaz IN. Clinical and functional results following femtosecond laser-assisted DSEK versus microkeratome-assisted DSAEK surgeries. A comparative study. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirrgia. 2019;(1):20-26. (In Russ.). https://doi.org/10.25276/0235-4160-2019-1-20-26
  8. Shilova NF, Livny E, Anisimova NS, Antonova OP, Malyugin BE. Refractive outcomes following cataract combined with lamellar keratoplasty: femtosecond-DSEK versus microkeratome-DSAEK. Int Ophthalmol. 2021; 41(2):639-647.  https://doi.org/10.1007/s10792-020-01619-7
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  10. Malyugin BE, Shilova NF, Anisimova NS, Antonova OP. Transplantation of endothelium and Descemet’s membrane. Russian Annals of Ophthalmology = Vestnik oftal’mologii. 2019;135(1):98-103. (In Russ.). https://doi.org/10.17116/oftalma201913501198
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  24. Lam FC, Baydoun L, Satué M, Dirisamer M, Ham L, Melles GR. One year outcome of hemi-Descemet membrane endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol. 2015;253(11):1955-1958. https://doi.org/10.1007/s00417-015-3097-9
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