Parameters associated with endothelial cell density variability after Descemet membrane endothelial keratoplasty

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 09:37
Venue: Auditorium des Ministres.

First Author: L.Baydoun GERMANY
Co Author(s): S. Oellerich  K. Van Dijk  V. Bourgonje  L. Ham  G. Melles     

Abstract Details

Purpose:

To evaluate which parameters may affect endothelial cell loss after Descemet membrane endothelial keratoplasty (DMEK) by comparing eyes in the low versus high quartile of endothelial cell loss over a follow-up period of four years.

Setting:

Retrospective, interventional case series conducted at the Netherlands Institute for Innovative Ocular Surgery.

Methods:

Donor endothelial cell density (ECD) decline was evaluated for 351 eyes of 275 patients up to four years after DMEK for Fuchs endothelial corneal dystrophy (FECD). Eyes with a postoperative endothelial cell loss in the lower quartile at all available follow-up moments were assigned to Group 1 (n=51), and those in the upper quartile to Group 2 (n=42). Multinominal regression was used to assess which covariates were related to greater ECD decline.

Results:

Mean endothelial cell loss as compared to preoperative donor ECD for the entire study group was 33 (±16)%, 36 (±17)%, and 52 (±18)% at 1, 6 and 48 months postoperatively. Endothelial cell loss of Group 1 was 12 (±7)%, 13 (±6)%, and 26 (±8)% at respectively 1, 6 and 48 months postoperatively, and 59 (±10)%, 64 (±9)%, and 75 (±5)% in Group 2. Partial graft detachment, donor death cause cardiovascular/stroke (vs cancer), postoperative complications other than graft detachment and severity of preoperative FECD (all P<0.01) showed the strongest relation with greater ECD decline.

Conclusions:

DMEK eyes with a completely attached graft and operated in an early stage of FECD may show the lowest endothelial cell loss postoperatively.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company