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Simon Sheung Man Fung, Su-Yin Koay, Yusrah Shweikh, Olivia Li, Julia Elizabeth Theodossiades, Shima Shah, Khilan Shah, Romesh Angunawela, Mark Wilkins; Descemet membrane endothelial keratoplasty (DMEK) for endothelial failure: experience from Moorfields Eye Hospital, England.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1588.
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<br /> Descemet membrane endothelial keratoplasty (DMEK) is the latest instalment of endothelial keratoplasty. Its advantages over other forms of posterior lamellar keratoplasties include near-anatomical restoration, faster visual recovery and lower rejection rates. This study reviews the clinical outcomes of first series of patients who underwent DMEK in Moorfields Eye Hospital, England.
<br /> All patients who underwent DMEK in Moorfields Eye Hospital were included in this ongoing study. Clinical records were reviewed and data on surgical indication, visual outcomes and the rates for graft detachment and failure were analysed.
<br /> 103 patients underwent DMEK since December 2013, with 30 of them undergone combined cataract and DMEK surgery. Surgical indications included Fuchs endothelial dystrophy (64%), decompensated cornea (32%) and pseudophakic bullous keratopathy (4%). Pre-operative median best corrected visual acuity (BCVA) was 0.32 LogMAR (range: 0.20 - 0.50), and median central pachymetry was 681microns. Intra-operatively, all graft material were harvested by the operating surgeon, and no material was lost during donor harvesting. 64% of cases were completed with 20% sulfur hexafluoride (SF6) tamponade. Post-operatively, median BCVA was 0.12 LogMAR (range 0.08 - 0.36) and median pachymetry was 651microns. Median endothelial cell loss was 35% (range 20 - 40%) at 6 months. Partial graft detachment requiring rebubbling occurred in 36%, mainly in early cases when DMEK were first adopted. Total graft detachment and graft failure rates at 1 year were 7%. Only one episode of graft rejection was observed (1%). All failed grafts were replaced successfully with either DMEK or DSAEK.
<br /> Clinical outcomes of DMEK at Moorfields Eye Hospital were comparable to published series. Further standardisation in DMEK surgical techniques is needed to produce more consistent results.
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