Study of predictive factors corneal failure on DMEK (Descemet Membrane Endothelial Keratoplasty).

Abstract

Purpose : The main objective was to study the predictive factors of DMEK failure.

Methods : This is an observational, prospective and single-center study, including all patients who received a DMEK in our department from March 2014 to November 2017. The operative indications were mainly Fuchs dystrophies and keratopathies bullous. Were collected the following data : age of donors and recipients, sex, endothelial cell density (ECD) of grafts, operative time, type of phacoemulsification combined or not (triple procedure) and finally the marking or not of the stromal face of the graft. The primary endpoint was the graft failure, leading to the realization of a second transplant type reDMEK or DSAEK.

Results : Seventy three eyes of 56 patients were included, 48 women (66%) and 18 men (34%). The average age of recipients was 73 years (SD 10), and 75 years (SD 13) for the donors. The operating time was 36 min (SD 10). The number of triple procedure was 18 (25%). 18 grafts (25%) were marked. There were 16 failures (22%). In bivariate or multivariate analysis, the results on the primary endpoint were not statistically significant for all the criteria studied (age, sex, DCE, triple procedure and graft tagging). The stromal staining of the graft was nevertheless associated with 88% success, against only 74% for the unmarked grafts but this difference remained insignificant, because of the small sample size.

Conclusions : This study does not reveal any predictive factors for corneal transplant failure of the DMEK type. A multicenter, larger scale study may be needed.

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