Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with comorbid keratoconus and corneal endothelial dysfunction

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 09:43
Venue: Auditorium des Ministres.

First Author: P.Dockery USA
Co Author(s): J. Parker  R. Birbal  M. Tong  J. Parker  K. Joubert  G. Melles  

Abstract Details

Purpose:

To evaluate the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) performed in eyes with comorbid keratoconus (KC) and corneal endothelial dysfunction.

Setting:

Parker Cornea, Birmingham, AL, USA

Methods:

Twenty-three consecutive eyes of 14 patients with comorbid KC underwent DMEK for corneal endothelial dysfunction; best spectacle corrected visual acuity (BSCVA), maximum corneal curvature (Kmax), central corneal thickness (CCT), and intra- and postoperative complications were assessed.

Results:

Excluding eyes requiring re-transplantation for primary graft failure (n=3), all eyes showed improvement in BSCVA, reaching 20/40 (0.5) in 85%, 20/25 (0.8) in 50%, and 20/20 (1.0) in 25% by one month postoperatively; 88%, 69%, and 38% by 6 months postoperatively; and 83%, 67%, and 42% by 12 months postoperatively. CCT decreased from 594μm preoperatively to 484μm at 1 month (p<0.001) and 489μm at 12 months (p<0.001). Kmax decreased by a median of 1.9 diopters (D) at 1 month (p=0.003) and 2.8 D at 12 months (p=0.012), and every eye with a preoperative Kmax > 46 D demonstrated flattening.

Conclusions:

DMEK is technically feasible in eyes with comorbid KC and may give excellent visual and refractive outcomes, including significant corneal flattening, which may potentially create a visually significant hyperopic shift in patients with severely ectatic corneas.

Financial Disclosure: