Posters

Clinical outcomes of descemet membrane endothelial keratoplasty in patients over 85 years old

Poster Details

First Author: E.Livny ISRAEL

Co Author(s):    A. Achiron   Y. Nahum   I. Levy   R. Shehadeh-Mashor   U. Elbaz   I. Bahar     

Abstract Details

Purpose:

Many surgeons are reluctant to perform corneal transplantation in very elderly patients due to expected long rehabilitation, complications rate and difficulty to adhere to post-operative regime. DMEK, however, provides rapid visual rehabilitation and less post-operative care than other transplantations, thus age may not be a decision-making factor. The purpose of our study was to compare the results of patients over 85 years old that underwent DMEK versus the results of DMEK patients under 70 years old.

Setting:

Ophthalmology department in a Tertiary hospital - Rabin Medical Center, Petah-Tikva, Israel

Methods:

Data of all patients undergoing uneventful DMEK surgery between 2016 to 2018, with at least 3 months of follow-up were retrospectively collected. Data collected included indication for surgery, visual acuity and rate of postoperative complications. Outcomes comparison between patients over 85 years old to patients under 70 years were carried out. Kaplan–Meier plot served to assess graft failure rate in both groups.

Results:

Forty-eight DMEK cases were included: 27 patients over 85 years (mean 87.8±2.7) and 21 patients under 70 years (mean 59.3±7.4). Older patients had higher rate of bullous keratopathy (59.3% vs. 13.6%, p<0.001), lower rate of Fuchs dystrophy (14.87% vs 54.5%, p=0.004) and more pre-operative glaucoma (38.8% vs 14.2%, p=0.01). Both groups had a significant vision improvement following surgery. There were no differences in complications rate (graft detachment, macular edema and infectious keratitis). However, over the follow-up period, the >85 years group had higher failure rate (29.6% vs 4.7%, p=0.05) and shorter estimated graft survival time (29.0±4.8 vs 91.6±5.2 months, p=0.002)

Conclusions:

DMEK surgery is effective in the elderly population over 85 years with significant improvement in visual acuity, without major early postoperative complications. However, incidence of graft failure following DMEK in the older age group was higher and the estimated calculated graft survival time was shorter in the elderly group compared to the younger group.

Financial Disclosure:

None