Descemet Membrane Endothelial Keratoplasty (DMEK): two years of experience in Centro Hospitalar Universitário de São João

Abstract

Purpose: To evaluate the the results of the first two years of DMEK in Centro Hospitalar Universitário de São João (CHUSJ).

Methods: Retrospective analysis of all cases of DMEK surgery performed in CHUSJ.  Best corrected visual acuity (BCVA) and endothelial cell count were evaluated prior and postoperatively. Intraoperative and postoperative complications were documented.

Results: DMEK was performed in 24 eyes (23 patients) to manage corneal endothelial disorders. Patient’s mean age at DMEK surgery was 69,1 (from 41 to 86) years. Eleven males and 12 females were included. Endothelial transplant indications were Fuchs endothelial dystrophy in 14 eyes, bullous keratopathy in 8 eyes, one previous graft failure and one Iridocorneal endothelial syndrome). Considering the cases with, at least, one year of follow-up, the median BCVA improved significantly from 0.2 at baseline to 0.6 (0.2 to 1.0; p=0,003 Wilcoxon Test).

Three cases showed graft failure in the first postoperative month (2 bullous keratopathy and 1 central graft detachment), requiring regraft (1 DSAEK and 2 DMEK).

The mean follow-up time was 12,6 (from 1 to 25) months. The mean donor cell count was 2538 (2001-2996) cel/mm². First year mean endothelial cell count was 1225 (range 381 to 1875) cél/mm², with a mean endothelial cell loss of 45,1%.

No intraoperative complications were described. No tissue loss was reported during the preparation of the endothelial roll.  

Conclusion:  DMEK may offer visual acuity improvement and appears to be a safe and effective treatment for corneal endothelial diseases.