Chord Mu (µ) and Chord Alpha (α) Length Changes in Fuchs Endothelial Corneal Dystrophy before and after Descemet Membrane Endothelial Keratoplasty (DMEK) Surgery.

Carlos Rocha-De-Lossada,Víctor Llorens-Bellés,Josep Torras-Sanvicens,Davide Borroni,José-María Sánchez-González,Jorge Peraza-Nieves,Vito Romano,Rahul Rachwani-Anil

doi:10.3390/jcm10214844

Abstract

This paper will evaluate chord mu and alpha length in patients with Fuchs endothelial corneal dystrophy (FECD) and its changes following Descemet membrane endothelial keratoplasty (DMEK). Patients with FECD that underwent DMEK surgery were included in this retrospective study. Scheimpflug Tomography was carried out in order to calculate chord mu and chord alpha lengths prior to surgery and at 3 and 12 months postoperative. This study included 27 eyes from 27 patients. Significant changes in chord mu were observed within the first three months (from 0.47 ± 0.32 to 0.29 ± 0.21 mm, p < 0.01) and remained stable 12 months postoperative (0.30 ± 0.21 mm, p > 0.05). However, chord alpha remained stable throughout the 12 months post surgery (from 0.53 ± 0.19 to 0.49 ± 0.14 mm, p > 0.05). In addition to the pupillary center distance from the corneal center (from 0.35 ± 0.25 to 0.34 ± 0.20 mm, p > 0.05) also remain stable. In FECD patients undergoing DMEK surgery, chord mu length decreased, and chord alpha length remained stable after 12 months of follow-up.

Highlights

Introduction published maps and institutional affilDescemet membrane endothelial keratoplasty (DMEK) is the main endothelial transplantation technique [1,2,3]
Nanavaty et al [8] reported a patient with Fuchs endothelial corneal dystrophy (FECD) who provided successful results after a combined refractive lens exchange with a multifocal intraocular lens (MIOL) in addition to DMEK
Recently Wang et al [17] demonstrated that there were no significant changes between preoperative and postoperative angle alpha after cataract surgery, unlike in the kappa angle which significantly decreased. This is similar to our results where we found that chord alpha remained unchanged and chord mu decreased after DMEK

Summary

Introduction

Introduction published maps and institutional affilDescemet membrane endothelial keratoplasty (DMEK) is the main endothelial transplantation technique [1,2,3]. DMEK has proven to attain better results in visual acuity and a faster recovery compared to other corneal transplant techniques [4,5,6]. Birbal et al [7] reported that after five years of follow-up after DMEK surgery, graft survival is high, visual acuity outcomes are excellent, and there is a low long-term complication rate. Nanavaty et al [8] reported a patient with Fuchs endothelial corneal dystrophy (FECD) who provided successful results after a combined refractive lens exchange with a multifocal intraocular lens (MIOL) in addition to DMEK. Other cases of DMEK after corneal decompensation a few years after MIOL implantation in eyes with FECD have been described [9]. A large deviation between the visual axis and the pupillary axis of iations

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