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Analysis of Descemet's membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty and re-keratoplasty

Poster Details

First Author: A.Slavik Lencova GERMANY

Co Author(s):    T. Kohnen   B. Agha   I. Schmack              

Abstract Details

Purpose:

To report the outcomes of Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty (PK) and re-keratoplasty (re-PK).

Setting:

Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany

Methods:

Retrospective case series included six eyes of six patients who underwent DMEK for failed PK. In 2 out of 6 cases, the patients underwent DMEK surgery after one failed, in 4 after several failed penetrating re-keratoplasties. In one case, DMEK was combined with cataract surgery. The average patient age was 64.83 years. The average follow-up time was 15.0 months. The graft diameters of the failed PKs was 7.0, 7.6, 7.6, 7.9, 8.1 and 8.5 mm, respectively. The donor graft diameter was 7.0 mm (3 cases), 7.75 mm (one case) and 8.0 mm (2 cases). Preoperative and postoperative data were analyzed.

Results:

The final visual acuities were 0.80 (decimal), 0.40, 0.25, 0.25, 0.20 and 0.05 (due to re-DMEK graft decompensation), respectively. After DMEK surgery, 3 cases had a graft detachment and required rebubbling. In two cases, a re-DMEK surgery was required. In one case re-DMEK was performed 26 months postoperatively due to a DMEK graft decompensation with satisfactory postoperative results. The second case of re-DMEK required rebubbling and showed re-DMEK graft decompensation 12 months postoperatively.

Conclusions:

In this small cohort DMEK surgery seems effective in managing PK and re-PK failure; however, it remains challenging due to the complexity of those cases.

Financial Disclosure:

None

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