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Theofilos Tourtas, Andreas Schloegl, Julia Marina Weller, Friedrich E Kruse; Descemet membrane endothelial keratoplasty (DMEK): short-term success or long-term benefit?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1203. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Descemet membrane endothelial keratoplasty (DMEK) is still in its infancy and most studies focus on short-term issues like early clinical outcome and modifications of the technique. However the long-term benefit is yet to be elucidated. In the absence of long-term data after DMEK we performed an analysis of clinical outcome based on a 4-year follow-up.
This was a single-center, retrospective, consecutive case series of 97 eyes of 84 patients undergoing DMEK who completed a minimum of a 3-year follow-up. In the majority of patients (91%) indication for DMEK surgery was Fuchs endothelial dystrophy. Best-corrected visual acuity (BCVA) (in logarithm of the minimal angle of resolution [logMAR] units), endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated.
All graft preparations were uneventful. Mean follow-up was 43.7 ± 5.7 months. BCVA improved from 0.62 ± 0.43 logMAR before surgery to 0.17 ± 0.13 logMAR 3 months after DMEK (p<0.001, Wilcoxon test) and remained stable until the 4-year follow up (0.13 ± 0.08 logMAR). 69% of eyes without ocular comorbidities reached a visual acuity of 20/25 or better 4 years after DMEK. ECD was stable after the initial post-surgical decrease (42% at 1 month, 46% at 4 years). CCT decreased from 644 ± 66 μm before surgery to 559 ± 53 μm at 4 years, with a minimum of 530 ± 54 μm at 3 months.
The long-term benefit of DMEK was confirmed. DMEK not only provides fast visual rehabilitation but maintains its clinical outcome within a follow up of 4 years. Visual acuity and endothelial cell loss remain stable between 3 months and 4 years after surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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