Abstract
Purpose :
The purpose of our study was to investigate the pre-operative and post-operative anterior chamber depth measured by Scheimpflug tomography in eyes undergoing Descemet Membrane Endothelial Keratoplasty (DMEK).
Methods :
We conducted a retrospective chart review on patients who underwent primary or repeat DMEK between January 2015 and July 2023 at the Bascom Palmer Eye Institute. A total of 600 charts were reviewed, and ultimately 58 charts were included. Data collection included demographics, pre-operative and post-operative ACD, best corrected visual acuity, length of follow up and time to graft failure if it occurred. We excluded eyes with history of narrow angle glaucoma, history of chronic angle closure glaucoma, angle recession, history of retinal detachment, penetrating eye trauma, herpetic keratitis, uveitis, known iridodialysis, as well as the presence of an anterior chamber intraocular lens. Patients who did not receive pre-operative Scheimpflug images were also excluded.
Results :
A total of 77 eyes were analyzed, 72 undergoing single DMEK, and 5 requiring repeat DMEKs. The mean baseline pre-operative ACD for single DMEK was 3.02 ± 0.75mm, and for the repeat DMEK group was 3.02 ± 0.61mm (p=0.998). Post-operative DMEK for the single DMEK group was 4.01 ± 1.05mm versus post-operative DMEK after the initial DMEK in the repeat group was 2.82 ± 0.64mm, (p<0.001). Post-operative ACD after the second DMEK in the repeat group was 3.42 ± 0.95mm. The mean time to graft failure was 78 ±9 days after the initial DMEK.
Conclusions :
Our results demonstrate comparable pre-operative baseline ACD for both the single and repeat DMEK groups, and yet a statistically significant difference is seen in the post-operative ACD between the two groups. A larger post-operative ACD in eyes that did not require a repeat DMEK, compared to the eyes that required a repeat DMEK. A smaller post-operative ACD after DMEK may serve as a predictor of graft failure and a need for a repeat DMEK.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.