INCIDENCE AND OUTCOME OF CYSTOID MACULAR OEDEMA AFTER DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY

Published 2025 - 29th ESCRS Winter Meeting

Reference: PO193 | Type: Free Paper | DOI: 10.82333/yawb-j234

Authors: Davide Romano ¹ , Jennifer Kwan ¹ , Steven Isherwood ¹ , Marta Fernandez Gurria* ¹ , Navpreet Dhillon ¹

¹University Hospitals of Leicester NHS Trust,Leicester,United Kingdom

Purpose

To audit and review the case cystoid macular oedema, dectected at OCT, after DMEK performed in the last 5-year

Setting

University Hospitals of Leicester NHS Trust

Methods

Retrospective cohort study of DMEK performed between April 2018 and May 2023

Results

98 DMEK procedures have been performed. Of these, OCT was performed in 66 case (67.3% of total DMEK patient)

Number of patient who developed CMO: 7/66 (10.6%)

Onset of CMO within 6 weeks: 4/7 (57.1%)

Onset of CMO within 8 weeks: 6/7 (85.7%)

Onset of CMO within 3 months: 7/7 (100%)

Mean onset of CMO (weeks ± SD): 5.5 (± 2.29)

Duration of CMO (weeks ± SD): 17.8 (±14.14)

N° of CMO after triple procedure (DMEK + Phaco + IOL): 0

N° of recurrence of CMO after treatment: 3/7 (42,85%)

Risk factor for recurrence: Uveitis. 2/3 (75%) of recurrence occurred in patients with history of uveitis

N° patients who were on topical steroids (dexamethasone 0.1% PF) at time of CMO onset: 6/7 (85.7%)

Baseline systemic co-morbidities: 5/7 (71.4%) none; 2/7 (28.5%) diabetes

Type of treatment:

Topical Nepafenac 0.1% tds: 7/7 (100%)

N° patients requiring subtenon injection of triamcinolone 2/7 (28.57%)

N° requiring intravenous injection 1/7 (14.28%) [pt with graft rejection and CMO at same time]

Safety of treatment:

Glaucoma post-CMO treatment: 1/7 (14.28%)

Improvement of Visual Acuity:

•Overall: baseline 0.40 (± 0.20) logMAR >0.16 (± 0.08) (P-value 0.185)

Conclusion

1.Onset of CMO is commonly observed in the first 6 weeks 5.5 (± 2.29), subsequently close monitoring at OCT should be performed in the first 6 weeks.

2.Duration of CMO can be long (17.8 weeks ±14.14) > Counselling the patients with CMO that the duration can be long and has high variability.

3.Visual Acuity after CMO is generally good, apart in case of presence of diabetic retinopathy > advise patient at pre-op that outcome of DMEK can be limited by their diabetic retinopathy

4.Patient with history of uveitis are more at risk of recurrence > advise that response to treatment although is good may not be definitive and CMO may recur.