Skip to Main content Skip to Navigation
Master Thesis

Descemetorhexis sans kératoplastie endothéliale dans la dystrophie endothéliale de Fuchs : revue systématique et méta-analyse

Abstract : Purpose: To conduct a systematic review and meta-analysis on the outcomes of Descemetorhexis without endothelial keratoplasty (DWEK), associated or not with phacoemulsification (PKE) and Rho Kinase Inhibitor (RHOKI) in Fuchs Endothelial Corneal Dystrophy (FECD). Clinical Relevance: DWEK is an emergent corneal intervention that could be effective for patients with FECD. Method: PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and Science Direct databases were used to search for studies on DWEK surgery in patients with FECD, without language restriction, till 29th November 2020. We computed random-effect meta-analysis stratified by type of intervention and type of descemetorhexis size, and meta-regressions to compare between interventions and examine the influence of sociodemographic factors. PRISMA guidelines were followed and our search protocol was registered in PROSPERO (registration number CRD42020167566). Results: 11 articles were included in our systematic review, representing 127 eyes of 118 patients. DWEK globally improved visual acuity (effect size = -1.11, 95CI -1.70 to -0.52, P < 0.001) and pachymetry (-1.25, -1.92 to -0.57, P < 0.001), without significant effects on endothelial cell count (-0.59, -2.00 to 0.83, P = 0.419). The three types of interventions (i.e. DWEK±RHOKI, DWEK±PKE, and DWEK±PKE±RHOKI) improved visual acuity and pachymetry in early and mild stages of FECD. Descemetorhexis size ≤ 4 mm improved visual acuity (-0.72, -1.29 to -0.14, P < 0.001) and pachymetry (-0.68, -0.98 to -0.38, P < 0.001), whereas > 4 mm did not. Meta-regressions did not demonstrate significant results. Conclusion: DWEK, with or without PKE and/or RHOKI, improved visual acuity and pachymetry in early and mild stages of FECD, without efficacy on cell count. A descemetorhexis size ≤ 4 mm improved visual acuity and pachymetry.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03439478
Contributor : Santé Uca Connect in order to contact the contributor
Submitted on : Monday, November 22, 2021 - 11:45:48 AM
Last modification on : Tuesday, November 23, 2021 - 3:47:07 AM

File

Thèse FRANCESCHINO Adrien.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-03439478, version 1

Collections

Citation

Adrien Franceschino. Descemetorhexis sans kératoplastie endothéliale dans la dystrophie endothéliale de Fuchs : revue systématique et méta-analyse. Organes des sens. 2021. ⟨dumas-03439478⟩

Share

Metrics

Record views

32

Files downloads

2