Four year clinical outcome after Descemet's membrane endothelial keratoplasty (DMEK): results of the first 500 consecutive cases

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:48

Venue: Room A3, Podium 3

First Author: : S.Oellerich THE NETHERLANDS

Co Author(s): :    L. Baydoun   I. Dapena   L. Ham   K. van Dijk   G. Melles        

Abstract Details

Purpose:

To evaluate the clinical outcomes up to 4 years after DMEK for the first 500 consecutive cases.

Setting:

The Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.

Methods:

From a group of 500 eyes (393 patients), which underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), bullous keratopathy, failed corneal transplants and other endothelial indications, clinical outcomes [best-corrected visual acuity (BCVA), central endothelial cell density (ECD), and central corneal thickness] were evaluated before, and at 6, 12, 24, 36 and 48 months after DMEK and postoperative complications were documented.

Results:

At 12 months postoperatively, 81% of eyes reached a BCVA of ≥20/25 (≥0.8), 49% ≥20/20 (≥1.0), and 15% ≥20/18 (≥1.2) and remained stable thereafter. ECD decreased from preoperatively 2530 (±211) cells/mm2 on average by 37(±18)%, 40(±18)%, 45(±18)%, and 53(±18)%, at 6, 12, 24, and 48 months postoperatively, respectively. Re-transplantation was required for 8.6% of the eyes within the four year follow-up period, with the majority (5.2%) of re-transplantations performed within the first postoperative year. Main postoperative complication was partial graft detachment (15.8%) in the early postoperative period. Principal longer term complications are secondary graft failure (2.4%) and allograft rejection (2.6%).

Conclusions:

At 4 years, DMEK showed excellent visual outcomes, ECD decrease comparable to other keratoplasty techniques and a low complication rate.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented