title: Outcomes of Descemet membrane endothelial keratoplasty in phakic eyes.
abstract: OBJECTIVE
  To determine the clinical outcomes of isolated Descemet membrane transplantation (ie, Descemet membrane endothelial keratoplasty [DMEK]) in phakic eyes.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Phakic eyes from a larger group of consecutive eyes that had DMEK for Fuchs endothelial dystrophy were examined. The examination included corrected distance visual acuity (CDVA), subjective and objective refractions, endothelial cell density (ECD), and intraoperative and postoperative complications at 1, 3, and 6 months.
  
  
  RESULTS
  The study enrolled 52 phakic eyes from a group of 260 DMEK eyes. Of the phakic eyes, 69% reached a CDVA equal to or better than 20/40 (≥0.5) within 1 week and 85% reached equal to or better than 20/25 (≥0.8) at 6 months. Compared with an age-matched control group of pseudophakic eyes, phakic eyes had a similar visual rehabilitation rate, final visual outcome, mean ECD at 6 months (1660 cells/mm(2) ± 470 [SD]), minor hyperopic shift (+0.74 diopter), and graft detachment rate (4%). Visual acuity equal to or better than 20/13 (≥1.5) was limited to phakic eyes, suggesting better optical quality with the crystalline lens in situ. Temporary mechanical angle-closure glaucoma due to air-bubble dislocation behind the iris was the main complication (11.5%). Two eyes (4%) required phacoemulsification after DMEK.
  
  
  CONCLUSIONS
  In phakic eyes, DMEK may give excellent visual outcomes without an increased risk for complications. Visual acuities equal to or better than 20/13 (≥1.5) may indicate that the almost anatomic repair after DMEK is associated with near perfect optical quality of the transplanted cornea.
  
  
  BACKGROUND
  Dr. Melles is a consultant to D.O.R.C. International/Dutch Ophthalmic USA. No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.forename: Martin
authors.initials: M
authors.lastname: Dirisamer
authors.forename: Miguel
authors.initials: M
authors.lastname: Naveiras
authors.forename: Win Hou W
authors.initials: WH
authors.lastname: Tse
authors.forename: Korine
authors.initials: K
authors.lastname: van Dijk
authors.forename: Laurence E
authors.initials: LE
authors.lastname: Frank
authors.forename: Lisanne
authors.initials: L
authors.lastname: Ham
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D019781:Corneal Topography; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D007908:Lens, Crystalline / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology