Descemet membrane endothelial keratoplasty: early results in endothelial diseases

Abstract

Purpose The aim of the study was to evaluate the intraoperative complications and clinical outcome of descemet membrane endothelial keratoplasty (DMEK) in eyes with endothelial diseases. Design The study was designed as a prospective noncomparative interventional trial. Patients and methods In 13 eyes with visually significant endothelial diseases, the diseased endothelium and descemet′s membrane were stripped and replaced with a donor graft consisting of endothelium and descemet′s membrane. Intraoperative and postoperative complications were evaluated. Best spectacle corrected visual acuity, subjective and objective refraction, keratometric readings, endothelial cell density, and central corneal thickness at 3 months were documented. Results Seventeen DMEK procedures were performed. Reinjection of air into the anterior chamber was needed in nine eyes and the procedure failed in five eyes, requiring a repeat DMEK. Three months postoperatively all eyes showed a mean best spectacle corrected visual acuity of 0.36 ± 0.28 log MAR, a mean keratometric reading of 44.7 ± 1.7 D, a mean astigmatism of 2.16 ± 1.04 D, a mean endothelial cell density of 1881.71 ± 213.39 cells/mm 2 , and a mean central corneal thickness of 501 ± 27.52 μm. Conclusion Although many challenges exist when performing DMEK, this technique allows a quick and complete restoration of the visual potential in patients with corneal endothelial disorders.

Keywords

• Descemet membrane endothelial keratoplasty
• fuch′s endothelial dystrophy
• pseudophakic bullous keratopathy