Posters

First 100 DMEK cases: initial experience

Poster Details

First Author: H.Yassin EGYPT

Co Author(s):    R. Sobhi                    

Abstract Details

Purpose:

To analyse the results of the first 100 consecutive  DMEK  in cases of corneal decompensation  and to compare our initial  50 cases (group A) with the last 50 cases (group B)

Setting:

KASR EL EINI HOSPITAL

Methods:

This  retrospective study included 100  eyes   with corneal oedema due to endothelial decompensation . The age of the patients  ranged from 40 -80 years. All  had remarkable corneal oedema with corneal thickness between 600-900 um. The treatment goal was to remove the diseased endothelium and to replace it by new DM .In each case the DM was prepared in the same setting from donor cornea which has cell count more than 2500 cells /mm2 donor age more than 50 .Main outcome measures were  examination of the graft  ,  BSCVA , corneal thickness , endothelial cell count  and surgical complications

Results:

The main causes of corneal decompensation was pseudophakic corneal decompensation  (70 eyes) , phakic IOL (5 eyes )and fuch ‘s dystrophy  (25 eyes).DM detachment was 20 % in group A decreased to 4%in group B after shifting to  SF6 gas injection. Surgical difficulties as visualisation ,unfolding of the graft ,graft orientation  encountered in group A  were  markedly decreased in group B after modification of certain steps as size of the graft ,use of fiberoptic and   glycerin eye drops  and the use of S mark for graft orientation. BSCVA ranged from 0.1-0.3 in group A compared to 0.3.-1.00 in group B.

Conclusions:

DMEK  is a safe and effective technique in cases of corneal enothelial dysfunction but it i has a steep learning curve which can be facilitated by attending instruction courses ,learning tips of advices from experts enthusiasm to shift to this meticulous procedure. Proper selection of cases, use of SF6 gas ,use of smaller graft,use of S mark, use of fiberoptic and use of standarized technique facilitates the learning curve and improve the results tremendously.

Financial Disclosure:

None