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Mayte Arino, Ignacio Jimenez-Alfaro, Blanca Garcia Sandoval, Nicolás Alejandre, Maria Teresa Iradier, Pedro Arriola-villalobos; Clinical outome of 150 consecutive cases undergoing Descemet Membrane Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6293.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the clinical outcome of 150 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK) and to assess which parameters may have influenced the clinical outcome.
Consecutive 150 eyes of 138 patients presenting to the Eye Clinic underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), bullous keratopathy and failed corneal transplants. Data including patient demographics, best corrected visual acuity, endothelial cell counts were recorded at baseline, as well as 6 and 12 months after DMEK. Relationship between tissue unscrolling time and endothelial cell loss and postoperative complications were also documented.
At 6 and 12 months postoperatively, 95% of eyes reached a BCVA of ≥20/40 (≥0.5) and 47% ≥20/30 (≥0,8). Compared with preoperative ECD, mean postoperative ECD decreased by 41% and 43% at 6 and 12 months respectively (p<0,05 for all the time points). Eyes with FECD and attached grafts showed better BCVA outcomes and higher ECD (P < 0.05). There was no relationship between unscrolling time and ECL at 6 months by the Pearson correlation coefficient. Within the study period, there was 3 primary failure and no secondary graft failures. The overall rejection rate was 1,3%.
Clinical outcomes supports DMEK as a safe and effective treatment for endothelial failure up to 1 year after surgery, particularly for eyes operated on for FECD and with completely attached grafts. Surgeons do not need to rush on DMEK surgery because longer unscrolling times do not endanger the endothelium.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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