Posters

One-year outcome of Descemet’s membrane endothelial keratoplasty in Asian eyes

Poster Details

First Author: T.Hayashi JAPAN

Co Author(s):    S. Inoda   H. Takahashi   I. Oyakawa   H. Yokogawa   A. Kobayashi   N. Kato     

Abstract Details

Purpose:

To investigate factors associated with visual outcome and endothelial survival after Descemet’s membrane endothelial keratoplasty (DMEK) in Asian eyes.

Setting:

Department of Ophthalmology, Yokohama Minami Kyosai Hospital

Methods:

In this prospective, interventional, consecutive case series, 51 eyes of 42 patients who underwent DMEK were evaluated. Postoperative best corrected visual acuity (BCVA) and corneal endothelial cell density (ECD) were assessed at 12 months after surgery. Multiple regression analysis and stepwise variable selection were performed for parameters such as age, sex, axial length, preoperative visual acuity, re-bubbling, cornea diameter, graft size, filling rates of graft to host cornea (FR), iris damage scores, type of tamponade gas (air or gas), gas volume in the anterior chamber (AC) on postoperative day 1, and ECD loss rates at 12 months after surgery.

Results:

BCVA was significantly improved at 12 months after DMEK (p < 0.001). The ECD loss rate at 12 months after DMEK was 53.6 ± 17.3%. Stepwise variable selection showed that iris damage before DMEK (p < 0.001), age (p = 0.003), axial length (p = 0.026), and preoperative BCVA (p = 0.029) were associated postoperative BCVA. With regard to endothelial survival, the preoperative ECD and FR were important factors for ECD loss rates 12 months after DMEK (p = 0.019 and p = 0.001, respectively).

Conclusions:

Iris damage may be a possible aggravating and avoidable factor for worse postoperative BCVA after DMEK. Furthermore, larger size of the graft for the host cornea might be essential for ECD survival. Surgeons should pay attention to protection of the iris, avoid multiple surgeries, and use as large a graft as possible.

Financial Disclosure:

None