In an expert interview filmed at AAO 2018, Dr Deepinder Dhaliwal discusses the difference between Descemet membrane endothelial keratoplasty (DMEK) and descemetorhexis without endothelial keratoplasty (DWEK) for the treatment of Fuchs’ dystrophy. Dr Dhaliwal explains that in her recent study, corneal oedema was shown to clear on its own, in approximately 7 weeks, after a 4 mm descemetorhexis centred on the visual axis. She also describes that although patients may experience faster results in, terms of vision improvement, with DMEK, this procedure may incur more post-operative complications, such as increased intraocular pressure, when compared to DWEK.
In part 2 of her interview, Dr Deepinder Dhaliwal describes which patients make ideal candidates for descemetorhexis without endothelial keratoplasty (DWEK), and those that are contraindicated. Dr Dhaliwal also explains why some studies may have reported poor outcomes with DWEK. Reasons such as failure to provide rho kinase inhibitors as part of the post-operative management, or those with advanced corneal disease.
1. What are the limitations of the use of Descemet membrane endothelial keratoplasty (DMEK) for patients with Fuchs’ endothelial corneal dystrophy? (0:11)
2. What is the rationale for the use of descemetorhexis without endothelial keratoplasty (DWEK)? (0:50)
3. What were the findings of your recent study comparing the two treatment modalities? (1:47)
4. Which patients are best suited to treatment with descemetorhexis without endothelial keratoplasty (DWEK) and what are the contraindications? (0:11)
5. Why have some studies reported poor outcomes for DWEK? (1:05)
Speaker disclosures: Deepinder Dhaliwal has nothing to disclose in relation to this interview.
Filmed at the American Academy of Ophthalmology (AAO) 2018 Annual Meeting, Chicago, IL, US, 27–30 October 2018.
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