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S. Riss, B. O. Bachmann, K. Laaser, L. M. Heindl, C. Cursiefen, F. E. Kruse; Early Postoperative Function After Descemet Membrane Endothelial Keratoplasty (DMEK) Seems to be Independent of Donor Tissue Characteristics. Invest. Ophthalmol. Vis. Sci. 2010;51(13):765.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the influence of donor tissue characteristics on early postoperative function in patients after DMEK.
To evaluate significant donor tissue characteristics (storage method, mean time in culture medium, donor post-mortem time, donor endothelial cell count (ECC) and donor age) 30 consecutive eyes of 30 patients with Fuchs endothelial dystrophy were analyzed. Functional outcome after 4 weeks was measured as best corrected visual acuity. Two groups were formed, one of which contained patients with significant improvement (improvement by more than 100 % of preoperative function; n=18) and the other contained patients with insignificant improvement (unchanged acuity or improvement of less than 100% of preoperative function; n=12).
BCVA in group 1 improved from 0.24 ± 0.13 (range, 0.05 - 0.4) to 0.56 ± 0.20 (range, 0.25 - 1.0) after 4 weeks follow up. In group 2 BCVA was 0.26 ± 0.13 (range, 0.04 - 0.4) preoperatively and 0.30 ± 012 (range, 0.04 - 0.5) postoperatively. 14 patients in group 1 and 9 patients in group 2 received donor tissue stored in long term organ culture (Dulbecco's Modified Eagle Medium DMEM) at 34°C. Donor tissue that was stored in short term culture (OptisolTM-GS) at 4 °C was grafted to 4 patients from group 1 and to 3 patients from group 2. Donor tissue was stored for average 385 ± 112 days in group 1 and for 309 ± 134 hours in group 2. Donor ECC were 2565 ± 271 cells/mm2 in group 1 and 2657 ± 210 cells/mm2 in group 2. Mean donor age was 63 ± 15 years in group 1 and 65 ± 8 years in group 2. The mean donor post-mortem time was 9 ± 4 hours in group 1 and 8 ± 5 hours in group 2. No statistically significant correlation was observed between short-term postoperative visual outcome and storage method (p=0.860), mean time in culture medium (p= 0.059), donor post-mortem time (p= 0.470), donor age (p= 0.511) and donor ECC (p = 0.362).
Endothelial cell count, storage method, time in the culture medium, post-mortem time and donor age do not seem to affect the short-term visual outcome after DMEK. Therefore factors related to the surgical technique seem to determinate early postoperative function.
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