Outcomes of Descemet membrane endothelial keratoplasty (DMEK) after late failure of descemet stripping automated endothelial keratoplasty (DSAEK)

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 09:25
Venue: Auditorium des Ministres.

First Author: E.Franco ITALY
Co Author(s): E. Franco  A. Yu  A. Friehmann  L. Furiosi  M. Busin     

Abstract Details

Purpose:

To report the outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) performed after late failure of Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) with or without evidence of immunologic rejection.

Setting:

Tertiary Care Ophthalmology Department

Methods:

This prospective study included all eyes that underwent DMEK for failed DSAEK between February 2015 and October 2018. Main outcome measures were best spectacle corrected visual acuity (BSCVA), endothelial cell density (ECD), endothelial cell loss (ECL) and rejection rate. Patients were evaluated at 6 and 12 months postoperatively.

Results:

Of 45 eyes with late failure of DSAEK, 14 (31%) showed evidence of immunologic rejection. Excluding patients with ocular comorbidities, BSCVA significantly improved from 1.67±0.57 to 0.07±0.11(p<0.001) with 90% reaching ≥ 20/25 and 50% reaching ≥ 20/20. Baseline mean ECD was 2541±50 cells/mm2 which decreased to 1679±430 cells/mm2 1 year postoperatively. The mean ECL was 33±17% at 1 year and was not statistically different after graft failure with(36±14%) or without(33±19%) immunologic rejection(p=0.723). The rate of rejection which occurred in a case of DSAEK failure with rejection was 2.2%. One year graft survival was 98%.

Conclusions:

DMEK after late failure of DSAEK yields excellent visual outcomes and survival rates after 1 year.

Financial Disclosure: