In vivo endothelial cell density decline in the early postoperative phase after Descemet's membrane endothelial keratoplasty (DMEK)

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

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

Paper Time: 14:42

Venue: Room A3, Podium 3

First Author: : L.Ham THE NETHERLANDS

Co Author(s): :    A. Miron   L. Baydoun   I. Dapena   S. Oellerich   M. Bruinsma   G. Melles     

Abstract Details

Purpose:

To evaluate endothelial cell density (ECD) in the first six months after Descemet membrane endothelial keratoplasty (DMEK) by eliminating method-error as a confounding variable.

Setting:

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

Methods:

From 24 DMEK eyes operated on for Fuchs endothelial corneal dystrophy, from which specular microscopy images could be taken at one day as well as six months postoperative, ECDs were compared between these two time points.

Results:

Using the 1-day ECD measurement as a baseline, mean ECD decreased from 1913 (±326) cells/mm2 to 1524 (±393) cells/mm2 at six months, a decline of -18 (±19) %. With the 1-week ECD as a baseline (1658 (±395) cells/mm2), the decline at six months was -6 (±19) % and when using preoperative ECD as a baseline (2521 (±122) cells/mm2) the decline was -39 (±16) % at six months.

Conclusions:

After DMEK, ECD shows an in-vivo decline of -18% from 1 day to six months postoperatively, with a sharp -13% drop in the first week, and a slower decrease thereafter. The remaining difference of 20% to preoperative ECD values may be attributed to measurement error in the eye bank with an overestimation of the graft's viable endothelial cell population and/or intraoperative trauma to the graft.

Financial Disclosure:

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