Outcomes of hemi-Descemet's membrane endothelial keratoplasty for Fuchs' endothelial corneal dystrophy

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

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

Paper Time: 14:54

Venue: Room A3, Podium 3

First Author: : R.Birbal THE NETHERLANDS

Co Author(s): :    V. Zygoura   J. Parker   L. Ham   I. Dapena   L. Baydoun   G. Melles     

Abstract Details

Purpose:

To report the mid-term outcomes of Hemi-Descemet membrane endothelial keratoplasty (Hemi-DMEK) performed for Fuchs endothelial corneal dystrophy (FECD).

Setting:

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

Methods:

Prospective, interventional case series, evaluating clinical outcomes of 10 eyes from 10 patients that underwent Hemi-DMEK for FECD. Main outcome measures were best corrected visual acuity (BCVA), endothelial cell density (ECD), central pachymetry and postoperative complications.

Results:

One year postoperatively, 7/7 eyes reached a BCVA of ≥20/40, and 6/7 ≥20/25. BCVA remained stable until 2 years (P≥.05) and improved thereafter (P<.05). ECD declined from 2740 (±180) to 850 (±300) cells/mm2 at 1 year (P≤.05) and showed a 6-7% annual decrease thereafter. Pachymetry decreased from preoperatively 745 (±153) to 533 (±63) μm and 527 (±35) μm at 1 and 3 years postoperatively. Four eyes needed re-bubbling; one of these underwent secondary DMEK for persistent graft detachment; another eye developed secondary graft failure 2.5 years postoperatively. One eye was suspected for allograft reaction 1.5 years postoperatively.

Conclusions:

Hemi-DMEK may render visual outcomes comparable to conventional DMEK. Despite low ECD counts by 6 months, ECD levels remain fairly stable thereafter. Hence, Hemi-DMEK may become a potential alternative technique for the treatment of FECD while increasing the yield of the endothelial tissue pool.

Financial Disclosure:

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