Wanted: Best surgery for corneal inner layer disease

The Department of Ophthalmology at University Hospital Cologne and the Faculty of Medicine has successfully raised funding of around 730,000 euros for a European multicentre clinical study. The aim is to investigate the best surgical procedure for patients with a corneal inner layer disease (Fuchs’ endothelial dystrophy) and simultaneous clouding of the lens (cataract). It is now possible to treat both diseases in a combined operation by cataract surgery and transplantation of the corneal endothelium (Descemet Membrane Endothelial Keratoplasty = DMEK).

“This new combined operation can mean overtreatment for patients with only minor damage to the corneal endothelium, which is why cataract surgery alone could be sufficient for those affected. On the other hand, if cataract surgery is performed alone, there is a risk that the corneal disease will worsen and lead to further clouding of the cornea,” explains Prof. Dr. Björn Bachmann, senior ophthalmologist at the Department of Ophthalmology at Cologne University Hospital. Prof. Bachmann is also conducting research on this topic together with Prof. Margarete Odenthal from the Department of Pathology at the University Hospital of Cologne in the SFB 1607 A01 project “Site-specific chronic inflammation and fibrosis in Fuchs corneal endothelial dystrophy”.

The new study aims to find criteria for deciding when cataract surgery alone is sufficient and when cataract surgery should be combined with DMEK as a so-called triple DMEK. The question is highly relevant as both diseases are increasingly occurring together in people over the age of 60.

In the study, patients are randomized (randomly selected) to undergo cataract surgery alone or in combination with transplantation of the corneal inner layer (triple DMEK). The study was designed by the Cologne Eye Clinic under the direction of Prof. Björn Bachmann and Prof. Claus Cursiefen.

The University of Cologne is the sponsor of this Investigator Initiated Trial (IIT). Centers specializing in cornea from Denmark (Aarhus, Prof. Hjortdal), the Netherlands (Nijmegen, Dr. Nobacht) and Spain (Barcelona, Prof. Güell) will participate in the study.