Posters

Descemet’s membrane endothelial keratoplasty for corneal decompensation: Outcomes and complications from UK single-centre experience

Poster Details

First Author: M.Nahaboo Solim UK

Co Author(s):    A. Alsafty   T. Patel                 

Abstract Details

Purpose:

Descemet’s membrane endothelial keratoplasty (DMEK) is one of the two different techniques of corneal transplantation for corneal decompensation, with the other one being Descemet’s stripping automated endothelial keratoplasty (DSAEK). The two main causes of corneal decompensation are Fuch’s endothelial dystrophy and traumatic cataract surgery. This study was carried out to evaluate the outcomes and complications from DMEK at a single centre in the UK (UK).

Setting:

Our study looked at data collected on 35 patients at our Ophthalmology department based a major general hospital in the North-East region of the UK. Our department provides a general ophthalmology as well as other medical retina, vitreo-retinal, glaucoma, corneal, paediatric, oculoplastic services.

Methods:

This study was carried out to evaluate the outcomes and complications from DMEK at a single UK centre. Data collection was performed retrospectively from case notes and included patients up to 2.7 years since DMEK started at our centre. Primary outcome measures included best-corrected visual acuity (BCVA) and central corneal thickness (CCT). Complications included graft detachment, graft failure, cystoid macular oedema (CMO) and raised intra-ocular pressure (IOP). Our standards were based on the American Academy of Ophthalmology (Deng et al. 2018) and Dirisamer et al. 2012.

Results:

We included 35 patients (10 males; 25 females) with a mean age of 77 years. The mean follow-up time was 1.36 years. Mean decrease in CCT over 100 weeks was 160 µm. BCVA improved to 6/12 and better by 3 weeks. Partial graft detachment was the most common complication (n=8; 22.9%) and 6 patients were treated successfully with air injection. 1 patient had graft failure and needed a DSAEK. 1 patient developed Urrets-Zavalia syndrome. 4 patients developed CMO and 1 patient developed raised IOP which did not require any treatment.

Conclusions:

Our data shows that DMEK is effective in terms of BCVA at 52 and 100 weeks, and comparable to other studies looking at DMEK. The CCT started to be in the normal range starting from one week following DMEK, showing the rapid improvement achieved. Partial graft detachment (<10 %) and CMO (13.9 %) rates were comparable to other major studies. The other complication rates were low. Our study shows that DMEK is effective and safe for the treatment of corneal decompensation at our centre. We aim to gather data for a regional multi-centre comparison in the future.

Financial Disclosure:

None