Posters
Preliminary outcome of hemi-Descemet's membrane endothelial keratoplasty for Fuchs endothelial dystrophy
Poster Details
First Author: N. Gerber-Hollbach SWITZERLAND
Co Author(s): J. Parker L. Baydoun V. Liarakos L. Ham I. Dapena G. Melles
Abstract Details
Purpose:
To evaluate the clinical outcome of a full-diameter, untrephined, semi-circular Descemet graft in a consecutive series of Descemet membrane endothelial keratoplasty (hemi-DMEK), potentially allowing the harvesting of two grafts from a single donor corneo-scleral rim.
Setting:
Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.
Methods:
Interventional case series of ten eyes of ten patients with Fuchs endothelial dystrophy. Best corrected visual acuity (BCVA), endothelial cell density (ECD), and central corneal thickness (CCT) were evaluated up to six months postoperatively, and intra- and postoperative complications were recorded.
Results:
Hemi-DMEK was successful in nine out of ten eyes; one eye showed persistent graft detachment despite re-bubbling and underwent a secondary DMEK. BCVA improved in all successful hemi-DMEK eyes. Preoperative donor ECD declined from 2744 (±181) cells/mm2 to 940 (±380) cells/mm2 centrally at six months postoperatively (n=9), with endothelial cell redistribution over bare stromal areas. Average CCT decreased from 745 (±153) µm preoperatively, to 520 (±37) µm at six months. Four eyes required re-bubbling for visually significant graft detachment. No other complications occurred throughout the study period.
Conclusions:
Hemi-DMEK may give visual outcomes similar to those in conventional DMEK. If ECD decrease and graft detachment rate would prove acceptable in larger series, hemi-DMEK could have the potential to double the availability of donor tissue for endothelial keratoplasty.
Financial Disclosure:
One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
