Mid-term results of Descemet membrane endothelial keratoplasty (DMEK): 4 to 7 years clinical outcome

Session Details

Session Title: Cornea
Session Date/Time: Sunday 28/02/2016 | 08:30-11:00
Paper Time: 10:42
Venue: MC2 Room
First Author: : V.Liarakos GREECE
Co Author(s): :    L. Ham   I. Dapena   K. van Dijk   L. Baydoun   A. Ilyas   G. Melles

Abstract Details

Purpose:

To evaluate the mid-term outcomes of Descemet membrane endothelial keratoplasty (DMEK) up to 4-7 years after surgery.

Setting:

A total of 250 eyes of 209 patients who underwent DMEK for Fuchs endothelial dystrophy, bullous keratopathy or previous corneal transplant failure and had at least 4 years of follow-up.

Methods:

Recipient eyes were examined before DMEK and postoperatively at 1 day, 1 week, 1 month, 3 months, 6 months, 1 year and yearly thereafter. Best corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications are the main outcome measures.

Results:

At 6 months after surgery, 91% of the eyes reached a BCVA of ≥20/40 (0.5), 73% ≥20/25 (0.8), 44% ≥20/20 (1.0) and 15% ≥20/17 (1.2) and remained stable up to 7 years (P>0.05). After an initial drop of 33.9% in the first 6 months, ECD declined by a yearly rate of 9.0%, up to 7 years (P>0.05). Re-bubbling rate was 4.4%. Re-transplantations were performed in 15.2% of cases to manage significant detachment (9.6%), primary graft failure (1.6%) or secondary graft failure (2.0%). The main complications after 6 months were allograft rejection (2.4%) and secondary graft failure (2.0%).

Conclusions:

After DMEK, the visual acuity level achieved at 6 months may remain stable up to at least 4-7 years, ECD shows a constant, slow decrease, and complications after the first 6 months occur in <5% of cases.

Financial Disclosure:

NONE