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Clinical outcomes of Descemet's membrane endothelial keratoplasty (DMEK) in pseudophakic eyes compared to Triple-DMEK at 1 year follow-up

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First Author: J.Fajardo-Sanchez UK

Co Author(s):    L. De Benito-Llopis                    

Abstract Details

Purpose:

To compare the outcomes 1 year after Descemet Membrane Endothelial Keratoplasty (DMEK) in pseudophakic eyes versus combined phacoemulsification and DMEK (triple-DMEK).

Setting:

Moorfields Eye Hospital NHS Foundation Trust

Methods:

Design: retrospective, interventional, consecutive case series. Methods: We analysed all eyes who underwent DMEK from 01/01/2017 to 30/06/2018 at Moorfields Eye Hospital. We selected those who underwent DMEK in a pseudophakic eye (DMEK group) and those who underwent triple-DMEK. Only the first graft performed in each eye was included. High risk cases were excluded: DMEK on a penetrating keratoplasty, previous glaucoma surgery, infection. We compared graft survival rate at 1 year and rebubbling rates.

Results:

446 eyes were included (263 eyes DMEK group, 183 eyes triple-DMEK group). The survival rate at 1 year was 80.60% after DMEK and 88.52% after triple-DMEK(p=0.02). When only FED cases were included (173 DMEK only; 180 triple-DMEK), no significant difference was found (86.70% vs 85.55% respectively, p=0.75). Within the DMEKonly group, the survival rate was higher in FED cases (86.7%) compared to PBK cases (67.4%)(p=0.0002). Rebubbling rates were 20.53% (DMEK group) and 16.93% (triple-DMEK group)(p=0.34). The use of SF6 or placing corneal sutures, did not seem to influence the rebubbling or dislocation rates in both groups (p=0.86, p=0.56; p=0.83, p=0.48).

Conclusions:

Conclusions: In our FED cases, performing phacoemulsification before DMEK or doing a combined procedure did not seem to affect the re-bubbling or survival rate up to 1 year postoperatively. PBK was associated with a higher failure rate compared to FED.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented