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Two-year clinical outcome after Descemet membrane endothelial keratoplasty using a standardized protocol
Authors:K S Siddharthan  Varna Shet  Anushri Agrawal  Jagdeesh Kumar Reddy
Affiliation:Head-Cornea Services, Sankara Eye Hospital, Coimbatore, India;1.DNB Student, Sankara Eye Hospital, Coimbatore, India;2.Fellow, Cornea Services, Sankara Eye Hospital, Coimbatore, India;3.Director, Technical, Sankara Eye Hospital, Coimbatore, India
Abstract:Purpose:The purpose of this study is to evaluate 2-year clinical outcome after Descemet membrane endothelial keratoplasty (DMEK) in a variety of endothelial dysfunctions using a standardized protocol.Methods:From a group of 230 eyes which underwent DMEK for Fuchs'' endothelial corneal dystrophy (FECD), aphakic and pseudophakic bullous keratopathy, failed full thickness corneal transplants, ICE syndrome, failed DSEK, and TASS the clinical outcomes best spectacle-corrected visual acuity (BSCVA), central endothelial cell density (ECD)] were evaluated before, and at 6, 12, and 24 months and the success rate, failure rate and postoperative complications were also analyzed.Results:Out of 230 eyes, 144 eyes (70%) had BSCVA 6/9 or better 2 years postoperatively. Mean donor ECD was 2692.23 (range, 2300–3436) cells/mm2 preoperatively, which was reduced to 1433.64 (range, 619.0–2272.0) cells/mm2 2 years after DMEK surgery, indicating a mean reduction of 1258 cells/mm2 (46%) in ECD.Conclusion:DMEK is a highly successful surgical procedure when following a standard protocol for treating diseases of the corneal endothelium providing a near perfect anatomic restoration and a high degree of visual rehabilitation.
Keywords:Corneal endothelium  Descemet membrane  Descemet membrane endothelial keratoplasty  Standardized technique
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