Longer-term results of Descemet's membrane endothelial keratoplasty (DMEK): 4 to 7 years clinical outcome

Session Details

Session Title: Moderated Poster Session: Miscellaneous
Session Date/Time: Saturday 11/02/2017 | 13:00-14:15
Paper Time: 13:24
Venue: Poster Area


First Author: L. Ham THE NETHERLANDS
Co Author(s): R. Quilendrino  I. Dapena  L. Baydoun  S. Oellerich  G. Melles     

Abstract Details

Purpose:

To evaluate the clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) up to 4-7 years postoperatively.

Setting:

Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.

Methods:

A total of 250 consecutive eyes of 209 patients who underwent DMEK at our institute and had potentially at least 4 years of follow-up were retrospectively evaluated. Main outcome measures were best corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), graft survival rate and postoperative complications.

Results:

At 6 months postoperatively, 73% of eyes reached a BCVA of ≥20/25 and 44% ≥20/20, and remained stable up to 7 years (P=.7114). ECD dropped by 33.9% in the first 6 months, and then declined by a yearly rate of 9.0%. Cumulative survival rate at 7 years was 0.96 (95% CI=[0.93, 0.99]).Re-bubblings were performed in 4.4%, all within the first 6 postoperative months. Re-transplantations were performed in 15.2% to manage graft detachment (11.6%), or graft failure (3.6%), with the majority performed within the first year. After 6 months, the main complications were allograft rejection (2.4%) and secondary graft failure (2.0%).

Conclusions:

The visual acuity level achieved at 6 months after DMEK, may remain stable up to at least 4-7 years, ECD shows a constant, slow decrease, and complications after the first 6 months occur in <5% of cases.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented