Descemet's membrane endothelial keratoplasty: 2 year clinical outcome results of the first 500 consecutive cases

Session Details

Session Title: Cornea
Session Date/Time: Sunday 28/02/2016 | 08:30-11:00
Paper Time: 10:36
Venue: MC2 Room
First Author: : J.Peraza-Nieves, MD THE NETHERLANDS
Co Author(s): :    I. Dapena   L. Baydoun   S. Oellerich   G. Melles     

Abstract Details

Purpose:

To evaluate the clinical outcome up to two years after Descemet membrane endothelial keratoplasty (DMEK) for the first 500 consecutive cases.

Setting:

Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center

Methods:

In 500 eyes of 393 patients who underwent DMEK at a tertiary referral center for Fuchs endothelial dystrophy, bullous keratopathy or previous corneal transplant failure best corrected visual acuity (BCVA), endothelial cell density (ECD), pachymetry and postoperative complications were evaluated before, and 6, 12 and 24 months after DMEK.

Results:

At 2 years follow-up, BCVA was 82% of eyes reaching a BCVA of ≥20/25 (≥0.8), 52% ≥20/20 (≥1.0) and 16% ≥20/18 (≥1.2) (n=360). Mean ECD decreased to 1600 cells/mm2 (n=447), 1530 cells/mm2 (n=427), and 1400 cells/mm2 (n=392) at 6, 12 and 24 months, respectively, corresponding to a decrease of 37(±18)%, 40(±18)%, and 45(±18)%, respectively, compared to preoperative ECD. Postoperative pachymetry averaged 525 (±46) µm at 6 months and remained stable up to 2 years. 32 eyes (6.4%) required re-transplantation within the first 2 years. Main longer term complications were secondary graft failure and allograft rejection.

Conclusions:

BCVA outcomes after DMEK are excellent up to 2 years, while ECD decrease corresponds to those of other keratoplasty techniques. With the low longer term complication rate, DMEK may become the first choice of treatment in corneal endothelial disease.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a competing company