July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Preliminary results of a multicenter randomized clinical trial comparing Descemet Membrane Endothelial Keratoplasty (DMEK) with ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK)
Author Affiliations & Notes
  • Mor M. Dickman
    University Eye Clinic, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
    MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, Netherlands
  • Suryan Dunker
    University Eye Clinic, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
  • Robert Wisse
    Utrecht Medical Center, Utrecht, Netherlands
  • Robert J. Wijdh
    Groningen University Medical Center, Groningen, Netherlands
  • Siamak Nobacht
    Radboud UMC, Nijmegen, Netherlands
  • Marjolijn C. Bartels
    Deventher Ziekenhuis, Deventher, Netherlands
  • Mei L. Tang
    Gelre Ziekenhuis, Appeldoorn, Netherlands
  • Frank JHM van den Biggelaar
    University Eye Clinic, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
  • Tos TJM Berendschot
    University Eye Clinic, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
  • Rudy MMA Nuijts
    University Eye Clinic, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
  • Footnotes
    Commercial Relationships   Mor Dickman, None; Suryan Dunker, None; Robert Wisse, None; Robert Wijdh, None; Siamak Nobacht, None; Marjolijn Bartels, None; Mei Tang, None; Frank van den Biggelaar, None; Tos TJM Berendschot, None; Rudy Nuijts, None
  • Footnotes
    Support  Netherlands Association for Health Research and Development (ZonMw)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1576. doi:
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      Mor M. Dickman, Suryan Dunker, Robert Wisse, Robert J. Wijdh, Siamak Nobacht, Marjolijn C. Bartels, Mei L. Tang, Frank JHM van den Biggelaar, Tos TJM Berendschot, Rudy MMA Nuijts; Preliminary results of a multicenter randomized clinical trial comparing Descemet Membrane Endothelial Keratoplasty (DMEK) with ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK). Invest. Ophthalmol. Vis. Sci. 2018;59(9):1576.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare best corrected visual acuity, endothelial cell density, and complications after Descemet Membrane Endothelial Keratoplasty (DMEK) and ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK).

Methods : Multicenter prospective randomized clinical trial (RCT). 55 eyes of 55 patients suffering from irreversible corneal endothelial dysfunction due to Fuchs' endothelial corneal dystrophy were randozmized to receive DMEK or UT-DSAEK in six tertiary and secondary eye clinics in the Netherlands. Donor grafts were centrally prepared by the Beverwijk Euro Cornea bank. Patients underwent ophthalmic examinations preoperatively and 3 months postoperatively.

Results : Preoperative BCVA did not differ between both groups (DMEK:0.38±0.18 logMAR vs. UT-DSAEK:0.33±0.21 logMAR, P=0.32). Three months after the operation, BCVA improved significantly (P<0.001). However, there was no statistically significant difference in BCVA between both groups (DMEK: 0.16±0.16 vs. UT-DSAEK: 0.19±0.11 logMAR, P=0.59).
One graft in each group was damaged during preparation. Donor endothelial cell density (ECD) did not differ between both groups (DMEK:2668±168 vs. UT-DSAEK:2638±193 cells/mm^2). Three months after the operation, ECD was significantly higher after DMEK (1868±478 vs. 1295±673 cells/mm^2, P= 0.01). Rebubbling was required in 17% of cases after DMEK, and was not reuquired after UT-DSAEK. Primary graft failure requiring repeated transplantation occurred in 7% of cases after DMEK, but not after UT-DSAEK.

Conclusions : The preliminary results of this multicenter RCT indicate that DMEK and UT-DSAEK achieve a similar improvement in BCVA three months after the operation. However, DMEK was associated with a significantly higher complication rate. To the best of our knowlegde, this is the first report from a RCT comparing both transplantation techniques.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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