Outcomes and complications of Descemet's membrane endothelial keratoplasty vs penetrating keratoplasty and Descemet stripping automated endothelial keratoplasty: results from the Singapore Corneal Transplant Registry

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Sunday 08/10/2017 | 10:30-12:30

Paper Time: 10:54

Venue: Meeting Center Room I

First Author: : J.Woo SINGAPORE

Co Author(s): :    H. Htoon   M. Ang   D. Tan              

Abstract Details

Purpose:

To compare the graft survival, outcomes and complications of Descemet Membrane Endothelial Keratoplasty (DMEK) versus Penetrating Keratoplasty (PK) and Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in Asian eyes.

Setting:

A comparative study based on data from the Singapore Corneal Transplant Registry (SCTR), Singapore National Eye Centre.

Methods:

The clinical data, donor and recipient characteristics of patients who underwent primary PK, DSAEK, and DMEK for optical indications from January 1991 to February 2017 were recorded from the prospective cohort from the SCTR. A Kaplan-Meier graft survival analysis was performed and the cumulative incidence of complications such as graft rejection and glaucoma was analyzed.

Results:

A total of 2233 eyes were included in the study, of which 1448 eyes underwent PK while 711 eyes and 74 eyes underwent DSAEK and DMEK respectively. The overall 5-year survival for DMEK was superior to both PK and DSAEK (93.8% vs 68.4% vs 82.0%, P <0.001, log-rank test). With regards to complications, the DMEK group had a lower cumulative incidence of graft rejection (1.4% vs 34.7% vs 11.8%, P<0.05) and glaucoma (12.2% vs 24.0% vs 24.3%, P<0.05) compared to the PK and DSAEK groups respectively.

Conclusions:

In our series, the 5-year graft survival of DMEK was significantly better than that of PK and DSAEK. Eyes that underwent DMEK also had a lower incidence of complications such as graft rejection and glaucoma.

Financial Disclosure:

NONE