April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Early Postoperative Function After Descemet Membrane Endothelial Keratoplasty (DMEK) Seems to be Independent of Donor Tissue Characteristics
Author Affiliations & Notes
  • S. Riss
    Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany
  • B. O. Bachmann
    Ophthalmology, Friedrich Alexander University, Erlangen, Germany
  • K. Laaser
    Department of Ophthalmology, University of Erlangen-Nuernberg, Erlangen, Germany
  • L. M. Heindl
    Ophthalmology and Eye Hospital, University Erlangen, Erlangen, Germany
  • C. Cursiefen
    Dept of Ophthalmology, University of Erlangen Nuernberg, Erlangen, Germany
  • F. E. Kruse
    Department of Ophthalmology, University of Erlangen Nurnberg, Erlangen, Germany
  • Footnotes
    Commercial Relationships  S. Riss, None; B.O. Bachmann, None; K. Laaser, None; L.M. Heindl, None; C. Cursiefen, None; F.E. Kruse, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 765. doi:
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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)

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Abstract

Purpose: : To investigate the influence of donor tissue characteristics on early postoperative function in patients after DMEK.

Methods: : 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).

Results: : 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).

Conclusions: : 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.

Keywords: cornea: clinical science • cornea: endothelium 
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