Long-Term Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty (Dmek)

Published 2022 - 40th Congress of the ESCRS

Reference: FPT06.08 | Type: Free paper | DOI: 10.82333/w56d-0h89

Authors: Simon A Males ¹ , Deepa Viswanathan ¹ , John J Males* ¹

¹Envision Eye Centre,Sydney,Australia

Purpose

To evaluate the long-term visual and densitometric outcomes of Descemet membrane endothelial keratoplasty (DMEK).

Setting

Envision Eye Centre, Sydney

Methods

Retrospective review of consecutive DMEK cases performed by a single surgeon. The study included 57 eyes that underwent DMEK, 79% were primary and 21% were secondary DMEKs.

Outcome measures included best-corrected visual acuity (BCVA), higher order aberrations (HOA) and total corneal densitometry (CD) in gray scale units (GSU) at 0-2 mm zone. Follow up visits were at 1,3,6,12 and greater than (>)12 months.

Results

Indications included Fuchs’ endothelial dystrophy (81%), Pseudophakic bullous keratopathy (11%), and failed penetrating keratoplasty (7%). 31.6% cases were combined with cataract surgery.

Follow up achieved was 87.7%, 75.4%, 64.9%, 56.1% and 49.1% at 1,3,6,12 and >12 months respectively. LogMAR BCVA was 0.41 ± 0.28, 0.39 ± 0.43, 0.29 ± 0.31, 0.19 ± 0.21, 0.14 ± 0.20 and 0.14 ± 0.34 at preop,1, 3, 6, 12 and >12 months respectively. A significant improvement in BCVA was noted at 6 (p= 0.01), 12 (p = 0.003) and at >12 (p = 0.001) months. HOAs were unchanged.

A significant improvement in CD was noted from 48.59 ± 18.06 (preop) to 34.84 ± 12.80 (p <0.0001) at 12 months and to 33.98 ± 6.42 (p = 0.0001) at >12 months follow up.

Conclusions

DMEK improves visual outcomes with restoration of corneal clarity and endothelial function.