Abstract
Purpose :
To evaluate patients undergoing secondary Descemet Membrane Endothelial Keratoplasty (DMEK) after unsuccessful Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) or DMEK surgery in regard to changes in corneal densitometry (CD).
Methods :
Retrospective institutional case series of 39 eyes of 39 patients. Study groups included patients with secondary DMEK for graft failure after DSAEK (group 1, n=14) or DMEK (group 2, n=11). Patients with uneventful primary DMEK surgery served as controls (control group, n=14). CD, corrected distance visual acuity (CDVA), central corneal thickness (CCT), and endothelial cell density (ECD) were obtained preoperatively and 1, 6 and 12 months postoperatively.
Results :
A significant decrease of grayscale units (GSU) was observed in the 0-2 and 2-6 mm zones in all groups. Differences between secondary DMEK groups were insignificant at all time points. Controls showed significantly lower GSU than study group 1 and 2 preoperatively as well 1 and 12 months postoperatively. Pearson correlation showed significant correlations of CD and CDVA in group 1 and 2 in the 0-2 mm zone and 2-6 mm zone in group 2 at 12 months. In all groups, there were no significant correlations between CD and CCT in the postoperative course.
Conclusions :
A decrease in CD can be demonstrated after secondary DMEK. Nevertheless, CD values remain significantly higher than in controls. This might further point out the relevance of secondary corneal structural changes in patients with corneal decompensation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.