Hemi-Descemet's membrane endothelial keratoplasty: one year outcomes

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Tuesday 08/09/2015 | 08:00-10:30

Paper Time: 09:18

Venue: Room 10

First Author: : F.Lam UK

Co Author(s): :    L. Baydoun   M. Satue   M. Dirisamer   L. Ham   G. Melles        

Abstract Details

Purpose:

We evaluated the 1-year clinical outcomes after semi-circular Descemet membrane endothelial keratoplasty (hemi-DMEK) in this first case series in the world.

Setting:

Netherlands Institute for Innovative Ocular Surgery. Tertiary referral center in Rotterdam, The Netherlands.

Methods:

In three eyes of three patients with Fuchs endothelial dystrophy, best corrected visual acuity (BCVA), endothelial cell density (ECD), pachymetry, and intra- and postoperative complications were serially evaluated after transplantation of a semi-circular 12 mm diameter Descemet graft (hemi-DMEK graft).

Results:

All corneas cleared within 6 months and showed a stable pachymetry thereafter (527, 535 and 490 µm, respectively). Compared to preoperative measurements, average central ECDs dropped by 51% (56, 39, and 59% respectively) at three months, 53% (57, 38, and 63% respectively) at 6 months, and 59% (60, 47, and 71% respectively) at 12 months. Denuded stromal areas adjacent to the graft cleared and at 12 months peripheral ECD counts ranged from 724 to 1051 cells/mm2. At 12 months, BCVA was 20/22 (0.9), 20/40 (0.5, amblyopic eye) and 20/17 (1.2). No postoperative complications occurred throughout the study period.

Conclusions:

Hemi-DMEK may provide visual outcomes similar to those in routine DMEK at one year post operation. If so, hemi-DMEK could become the next step in endothelial keratoplasty, owing to its potential to double the yield of transplants from the same donor pool (two hemi-DMEK grafts can be prepared from one donor cornea).

Financial Interest:

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