Real-World Outcomes of Descemet Membrane Endothelial Keratoplasty: 5 Years Single-Center Experience
DOI:
https://doi.org/10.48560/rspo.28057Keywords:
Corneal Transplantation, Descemet Stripping Endothelial Keratoplasty, Fuchs’ Endothelial DystrophyAbstract
INTRODUCTION: Our objective was to evaluate the 5-year clinical outcomes of a case series after Descemet membrane endothelial keratoplasty (DMEK) in a tertiary hospital center.
METHODS: Retrospective, single-center, observational cohort revision of the DMEK surgeries performed between August 2016 and August 2022.
Main outcome parameters (survival graft, best-corrected visual acuity (BCVA) in logMAR scale, and central endothelial cell density (ECD) were recorded. Intra, postoperative complica- tions, and the need for subsequent keratoplasties were considered secondary outcomes.
RESULTS: A total of 69 DMEKs, in 56 patients, were performed in our center between Au- gust 2016 and August 2022. The mean age of the patients at surgery was 65.91 ± 11.82 years. A percentage of 62.5% were female while 37.5% male. The leading indication for surgery was Fuchs dystrophy, followed by pseudophakic bullous keratopathy, corneal decompensation from previ- ous keratoplasties, and bullous keratopathy associated with phakic lens. Mean BCVA improved from 0.75 ± 0.26 (LogMAR) to 0.24 ± 0.23 at 1 year follow-up (N=57, p<0.001)). At 5 years-follow-up (N= 9), mean BCVA was 0.44 ± 0.24 (range 0.1 – 0.7) and mean ECD was 854.75 ± 218.97 cells/mm2. After the first year, an annual rate of ECD loss was calculated to be 12.9% (range, 8.7% to 16.1%).
Six eyes needed rebubbling. Allograft rejection was diagnosed in only one eye. Overall graft survival was 95.5 ± 2.5% at six months, 94.0 ± 2.9% at 1 year, 88.3 ± 4.2% at 2 years and 75.7 ± 7.9% at 5 years. Ten eyes underwent retransplantation.
CONCLUSION: Most eyes that underwent DMEK showed stable clinical outcomes with an early significant improvement in visual acuity. The overall results suggest that DMEK is a safe and effective treatment option for corneal endothelial diseases.
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