Five year clinical outcome after Descemet membrane endothelial keratoplasty (DMEK): results of the first 500 consecutive cases

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 09:31
Venue: Auditorium des Ministres.

First Author: J.Peraza-Nieves SPAIN
Co Author(s): R. Birbal  S. Ni Dhubhghaill  L. Ham  S. Oellerich  G. Melles     

Abstract Details

Purpose:

To evaluate the longer-term clinical outcomes and graft survival up to 5 years after Descemet membrane endothelial keratoplasty (DMEK) for the first 500 consecutive cases.

Setting:

Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands

Methods:

From a group of 500 eyes (393 patients), which underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), bullous keratopathy, failed corneal transplants and other endothelial indications, clinical outcomes [best-corrected visual acuity (BCVA), central endothelial cell density (ECD), and central corneal thickness] were evaluated before, and up to 5 years after DMEK. Survival probability was calculated and postoperative complications were documented.

Results:

At 5 years postoperatively, 82% of eyes reached a BCVA of ≥20/25 (≥0.8), 54% of ≥20/20 (≥1.0), and 15% of ≥20/18 (≥1.2). Mean ECD decreased by 40(±18)% and 55(±18)%, at 1 and 5 years postoperatively, respectively. Re-transplantation was required for 8.8% of the eyes within the study period. Main postoperative complication was partial graft detachment (15.8%) in the early postoperative period. Principal longer term complications are secondary graft failure (2.8%) and allograft rejection (2.8%). Cumulative survival probability at 5 years was 90%, with higher rates for eyes operated on for FECD (93%) than for other indications (72%).

Conclusions:

At 5 years postoperatively, DMEK showed a high graft survival rate, excellent visual outcomes, an ECD decrease comparable to other keratoplasty techniques and a low complication rate.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a competing company, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented