Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Purpose: The aim of this study was to evaluate Descemets membrane Endothelial Keratoplasty (DMEK) as a novel technique in management of cloudy cornea due to corneal endothelial diseases. Methods: This is a prospective interventional case series study applied on thirty eyes of twenty nine patients who underwent a Descemet membrane endothelial keratoplasty (DMEK). This study was carried out from January 2016 to November 2020. Inclusion criteria includes postoperative bullous keratopathy (27 eyes) 90% and Fuchs endothelial dystrophy with cataract (3 eyes) 10 %. All patients underwent complete ophthalmological examination before surgery, including:Uncorrected visual acuity and Best corrected visual acuity (according to the snellen VA chart),Slit lamp examination,assessment of the IOP,endothelial cell density evaluation with specular microscopy using and Corneal thickness with the anterior segment OCT and corneal pachymetry. Follow up at first, third and six months:Slit lamp examination,Measuring IOP,Measuring UCVA and BCVA,Anterior segment OCT using Topcon triton Multimodal Swept Source OCT,Specular microscope measuring using non-contact TOPCON SPECULAR MICROSCOPE SP.2000P and Autorefractometer measuring. Results: As regard the visual acuity (VA) the mean pre-operative VA was 0.12± 0.09 that improved to 0.49± 0.16 one month post-operative, 0.59± 0.16 three months post- operative and 0.68±0.15 six months post-operative with statistically significant improvement of VA throughout the duration of the study. There was marked improvement in VA after DMEK surgery so that by the end of the first month 50.0% of patients achieve VA {u2265} 0.05 and only 3.3% can reach VA {u2265} 0.8. at the end of the 3rd month 86.70 % of cases can achieve VA {u2265} 0.5 and 13.3 % can reach VA {u2265} 0.8 and by the end of 6th month of follow up 93.3% of cases had VA {u2265} 0.05 and 26.7% had VA {u2265} 0.8

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