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Ten year graft survival and clinical outcomes after DMEK

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First Author: I.Vasiliauskaitė THE NETHERLANDS

Co Author(s):    S. Oellerich   L. Ham   I. Dapena   L. Baydoun   K. van Dijk   G. Melles     

Abstract Details

Purpose:

To evaluate the 10 year graft survival and clinical outcomes of the first case series after Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Retrospective, interventional case series conducted at the Netherlands Institute for Innovative Ocular Surgery.

Methods:

After excluding the very first 25 DMEK eyes that constitute the technique learning curve, the following 100 consecutive primary DMEK eyes (88 patients) were included. Main outcome parameters (survival, best-corrected visual acuity (BCVA), central endothelial cell density (ECD), central corneal thickness (CCT)) were evaluated up to 10-years postoperatively and postoperative complications were documented.

Results:

At 5 and 10 years after DMEK, respectively 68 and 57 out of 100 eyes were still available for analysis. Of those eyes, 82% and 89% reached a BCVA of ≥20/25 (0.8) at 5- and 10 years postoperatively, respectively. Preoperative donor ECD decreased by 59% at 5 years and 68% at 10 years postoperatively. Within 10 years, 4% of eyes developed allograft rejection, no primary graft failures occurred and 6% of the eyes developed secondary graft failure. Graft survival probability was 0.83 [95% Confidence Interval (CI), 0.75-0.92] and 0.79 [95% CI, 0.70 -0.88] at 5- and 10-years postoperatively, respectively.

Conclusions:

Most eyes operated in the pioneering phase of DMEK show excellent and stable clinical outcomes with low postoperative complication rates and promising graft longevity over the first decade after surgery. This suggests that DMEK may be a safe long-term treatment option for corneal endothelial diseases.

Financial Disclosure:

... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented