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One-year clinical outcomes of preloaded descemet membrane endothelial keratoplasty vs non-preloaded descemet membrane endothelial keratoplasty

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First Author: M.Boehm GERMANY

Co Author(s):    A. Wylegala   P. Leon   S. Ong Tone   J. Ciolino   U. Jurkunas        

Abstract Details

Purpose:

To compare one-year outcomes of preloaded Descemet membrane endothelial keratoplasty (pDMEK) and non-preloaded DMEK (n-pDMEK) in patients with Fuchs endothelial corneal dystrophy (FECD).

Setting:

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.

Methods:

This retrospective comparative cohort study consecutively included sixty-eight eyes with FECD who underwent either pDMEK (n=38) or n-pDMEK (n=30) performed by cornea fellows with an experienced surgeon between 2016 and 2018 at the Massachusetts Eye and Ear Infirmary. Exclusion criteria were previous surgery (other than uncomplicated cataract surgery), and any documented evidence of macular or other corneal diseases. Corrected-distance visual acuity (CDVA), central corneal thickness (CCT), intraocular pressure (IOP), patient characteristics, post-processing endothelial cell count (p-pECC), donor graft data, and complications were compared.

Results:

CDVA showed similar results for pDMEK (0.12±0.11 logMAR) and n-pDMEK (0.13±0.13 logMAR) (p=0.827). 66% of the pDMEK eyes and 57% of the n-pDMEK eyes achieved a VA of ≥0.1 logMAR, and 95% and 97%, respectively, achieved a CDVA ≥0.3 logMAR. The preoperative CCT of pDMEK and n-pDMEK (644±62.2 µm, 660.5±56.2 µm) decreased significantly after surgery (525.1±43.6 µm, 526.5±45.2 µm, p < 0.001) with no difference between groups (p=0.840). The p-pECC did not differ between pDMEK (2959.2±182.9 cells/mm2) and n-pDMEK (2939.3±278.7 cells/mm2) (p=0.484). Complication rates were comparable with just the rebubbling performed in a minor procedure room showing a lower rate for pDMEK (13.16%) compared to n-pDMEK (33.33%) (p<0.045).

Conclusions:

One-year clinical outcomes were similar between pDMEK and n-pDMEK procedures, rendering eye bank-prepared pDMEK tissues a useful tool in treatment of endothelial dysfunction.

Financial Disclosure:

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