Abstract
Purpose: :
To report results and complications following descemet membrane endothelial keratoplasty (DMEK) in comparison to penetrating keratoplasty (PKP).
Methods: :
We reviewed the charts of all patients undergoing DMEK surgery in 2011 for visual acuity and complications and compared these to a historical control group of PKP. Graft survival was assessed by means of the Kaplan-Meier method. We logarithmized visual acuity for summary statistics.
Results: :
Visual acuity averaged -0.89±0.78 logMAR before DMEK and -0.82±0.49 logMAR before PKP. Patients were followed in mean 49.6±42.2 days following DMEK and 469.2±313 days following PKP. Visual acuity at last follow up visit averaged -0.47±0.62 logMAR after DMEK and -0.47±0.46 afer PKP. 65% of patients after DMEK as well as after PKP reached a visual acuity >=0.5, whereas 40% after DMEK and 22% after PKP reached a visual acuity of >=0.8. A second surgical intervention after DMEK was necessary in 22% of the patients after DMEK (24% after PKP) and 14% of the grafts suffered failure after DMEK compared to 16% after PKP. Endothelial cell density averaged 1257+/520cells/mm2 after DMEK and 1497±522cell/mm² after PKP.
Conclusions: :
DMEK is a promising method for curing diseases of the corneal endothelium, reaching a much faster visual recovery compared to PKP. However, longer follow up is required to assess longevity of the grafts.
Keywords: cornea: clinical science • cornea: endothelium