Clinical outcomes of Descemet’s membrane endothelial keratoplasties (DMEK) performed at a multi-surgeon ophthalmic teaching hospital: a retrospective case series

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 09:14

Venue: Hall C1

First Author: : H.Ong UK

Co Author(s): :    K. Muthusamy   S. Fung   K. Saha   R. Stewart   M. Wilkins        

Abstract Details

Purpose:

DMEK has been introduced as an alternative to Descemet’s stripping endothelial keratoplasty (DSEK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) as a surgical treatment of patients with corneal endothelial dysfunction. Most published studies reporting DMEK patient outcomes were small case series at a single centre with one or two surgeons. The aim of this study is to evaluate the clinical outcomes of all patients who had DMEK performed by different surgeons in a large multi-surgeon ophthalmic teaching hospital.

Setting:

Moorfields Eye Hospital, London, United Kingdom

Methods:

This was a retrospective observation study investigating all cases of DMEK procedures performed at Moorfields Eye Hospital between July 2013 to December 2015. All patients who had DMEK procedures during this period had pre-operative data and post-operative data at 3-months and 6-months collected from a review of medical records. Data collected included patient demographics, ocular co-morbidities, pre- and post- operative visual acuities, central corneal thickness, corneal endothelial cell count, and reasons for graft failure. Donor graft characteristics were also recorded.

Results:

298 DMEK procedures were performed. Median age of patients was 71.0 years. 48.7% of cases were performed by a consultant surgeon. 35.2% had combined DMEK and cataract surgery. The most common indication for DMEK was Fuchs’ endothelial dystrophy (55.4%) Post-operative visual acuities at 3- and 6-months were significantly better than pre-operative levels (p<0.001). At 3-months, significant graft detachments occurred in 21.8%. 57.1% were refloated. Of grafts refloated, 20.8% were unsuccessful and required a repeat graft procedure (DMEK or DSAEK). In 2014, graft failure rates were 19.8% (3 months) and 20.8% (6 months). In 2015, the respective rates were 15.1% and 17.4%.

Conclusions:

Our results are similar to previously reported studies. In a multi-surgeon teaching hospital, DMEK is a successful technique for the treatment of corneal endothelial dysfunction with good visual outcomes and improvement of failure rates with time.

Financial Disclosure:

NONE