Purchase this article with an account.
Robert Siggel, Werner Adler, Tisha Prabriputaloong Stanzel, Claus Cursiefen, Ludwig M Heindl; Bilateral Descemet membrane endothelial keratoplasty (DMEK): analysis of clinical outcome in first and fellow eye. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1195.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
It is still unknown whether Descemet membrane endothelial keratoplasty (DMEK) is comparable in first and fellow eye. Therefore we performed a retrospective analysis of clinical outcome, complications and predictors in sequential bilateral DMEK.
We analyzed data of 60 patients (120 eyes) with corneal endothelial disorders who underwent bilateral sequential DMEK. Main outcome measures were Best-corrected visual distance acuity (BCVA), central corneal thickness, endothelial cell loss, rebubbling rate and graft or non-graft-associated complications measured 6 and 12 months after surgery.
BCVA, central corneal thickness and endothelial cell loss do not differ significantly after 6 and 12 months postoperatively in first versus fellow eyes (p > 0.05; respectively). Graft or non-graft-associated complications such as graft detachment, graft failure, graft rejection, anterior chamber inflammation or intraocular pressure decompensation do not differ significantly between both first and fellow eyes (p > 0.05; respectively).BCVA after 6 and 12 months postoperatively of the first eyes correlates significantly with 12-months BCVA from the fellow eyes (r = 0.454, p = 0.031; r = 0.602, p = 0.001; respectively). Nevertheless, it was not possible to identify BCVA for an influencing variable for fellow eye outcome in regression modeling. Early sequential DMEK does not increase the risk for early immune reactions in the fellow eye.
Clinical outcomes of first and fellow eye are comparable in patients after DMEK suggesting good fellow eye outcomes after successful first eye DMEK. Donor differences do not seem to significantly affect DMEK results when certain quality characteristics are maintained. No significant correlation in postoperative complications could be found in first and fellow eye DMEK surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only