Long-term Clinical Outcome After Descemet Membrane Endothelial Keratoplasty

Schlögl, A.; Tourtas, Theofilos; Kruse, Friedrich E.; Weller, Julia M.

doi:10.1016/j.ajo.2016.07.002

Cited by 119 publications

(91 citation statements)

References 46 publications

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“…[ 29 ] However, the allograft rejection rate was similar to previously reported range of 1% to 5% within the first postoperative year after DMEK. [ 6 8 19 30 31 32 ] Moreover, in contrast to other studies,[ 6 19 24 30 ] repeat transplantation procedures in our series were also less, because of less significant complications such as DM detachment, PGF, and SGF.…”

Section: Discussioncontrasting

confidence: 70%

Overall clinical outcomes of Descemet membrane endothelial keratoplasty in 600 consecutive eyes: A large retrospective case series

Basak¹,

Basak²,

Gajendragadkar

et al. 2020

Indian J Ophthalmol

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Purpose: To analyze the overall clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) in 600 consecutive cases. Methods: Retrospective, consecutive interventional case series operated by a single surgeon. Six hundred consecutive eyes of 524 patients with endothelial dysfunctions of different etiologies scheduled for DMEK were included in this study. All donor tissues were prepared by the operating surgeon during the procedure, using McCarey Kaufman medium or Cornisol-preserved cornea with endothelial cell density (ECD) of ≥2500 cells/mm 2 . Indications, postoperative best spectacle-corrected visual acuity (BSCVA), ECD, endothelial cell loss (ECL), and complications were analyzed postoperatively between 3 months and 2 years. Results: The commonest indication was post-cataract corneal edema/bullous keratopathy in 262 (43.7%) eyes followed by Fuchs′ endothelial corneal dystrophy 218 (36.3%). Vision affected comorbidities were present in 91 (15.2%) eyes. In phakic eyes with cataract (222; 37%), DMEK was combined with cataract surgery (Triple-DMEK). BSCVA of ≥20/25 was achieved in 41.0%, 46.4%, 49.2%, and 48.7% of eyes at 3, 6, 12, and 24 months, respectively and stabilized at 6 months ( P = 0.54). Mean ECD decreased from 2884 ± 178 cells/mm 2 ( n = 600) before surgery to 2223 ± 321 ( n = 597), 2099 ± 354 ( n = 524), 1918 ± 373 ( n = 374), and 1772 ± 439 cells/mm 2 ( n = 158) at 3, 6, 12, and 24 months respectively. The corresponding mean ECL was 22.9 ± 11.4%, 27.2 ± 12.4%, 33.5 ± 13.0%, and 38.6 ± 14.3%, respectively ( P < 0.05 for all-time points). The commonest complication was DM detachment in 59 (9.8%) eyes of which 23 (3.8%) eyes required rebubbling. Three (0.5%) eyes had primary graft failure. Endothelial rejection occurred in 7 (1.2%) eyes until the last follow-up. Conclusion: DMEK is a safe and effective procedure in different types of endothelial diseases with encouraging surgical and clinical outcomes. Complications are less and ECL percentage up to 2 years is acceptable.

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Section: Discussioncontrasting

confidence: 70%

Overall clinical outcomes of Descemet membrane endothelial keratoplasty in 600 consecutive eyes: A large retrospective case series

Basak¹,

Basak²,

Gajendragadkar

et al. 2020

Indian J Ophthalmol

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“…This suggests that endothelial cell survival and ultimately long-term graft survival may be similar for the two techniques; although larger datasets and longer follow-up are desirable to validate these trends. As yet there are few reports in the literature on DMEK outcomes beyond 4 years, but those that do exist have shown cell loss between 38 and 53% [25][26][27], which appears comparable to DSEK 5-year cell loss of between 49 and 67% across studies [8][9][10][11].…”

Section: Discussionmentioning

confidence: 85%

Descemet’s membrane endothelial keratoplasty: surgical outcomes and endothelial cell count modelling from a UK centre

Fajgenbaum

Kopsachilis

Hollick

2018

Eye

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“…Midterm and long-term graft survival after DMEK proves to be similar or superior to other keratoplasty techniques for the same indications. [27][28][29] Due to the reduced rejection rate in DMEK, topical corticosteroids can be tapered down earlier in the postoperative period and the patients can be kept on relatively weaker topical corticosteroids, thereby reducing the potential risk for steroid-induced glaucoma. 30 Saving money and tissue DMEK turns out to be a technique much cheaper than any other corneal transplantation and definitely cheaper than DS(A)EK and UT-DS(A)EK because no microkeratome and no sutures are required.…”

Section: Reducing Rejections and Secondary Glaucomamentioning

confidence: 99%

Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the way forward? Yes

Liarakos

Tsatsos

Satué

et al. 2017

Eye

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Long-term Clinical Outcome After Descemet Membrane Endothelial Keratoplasty

Cited by 119 publications

References 46 publications

Overall clinical outcomes of Descemet membrane endothelial keratoplasty in 600 consecutive eyes: A large retrospective case series

Overall clinical outcomes of Descemet membrane endothelial keratoplasty in 600 consecutive eyes: A large retrospective case series

Descemet’s membrane endothelial keratoplasty: surgical outcomes and endothelial cell count modelling from a UK centre

Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the way forward? Yes

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