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Starting DMEK without transition from DSAEK

Poster Details


First Author: P.Schollmayer SLOVENIA

Co Author(s): Z. Luznik   L. Lapajne   M. Hawlina              

Abstract Details

Purpose:

To present results of first cases of Descemet membrane endothelial keratoplasty (DMEK) and to determine whether endothelial keratoplasty can be successfully and safely performed when starting with DMEK without transition from Descemet stripping automated endothelial keratoplasty (DSAEK).

Setting:

Eye Hospital, University Medical Centre Ljubljana, Slovenia

Methods:

Retrospective study of first 25 eyes that underwent DMEK. The surgery was performed by one surgeon (PS) with no previous experience in DSAEK. Best spectacle-corrected visual acuity (BSCVA) was performed preoperatively, pre-existing ocular morbidity that influenced visual outcome was recorded and endothelial cell density (ECD) of the donor cornea was obtained by the eye bank before preparing the graft. Postoperative BSCVA, endothelial cell loss (ECL) were evaluated. Patients with pre-existing ocular comorbidity that influenced visual performance including macular disease, advanced glaucoma, optic neuropathies and amblyopia were excluded from the analysis of BSCVA. Intraoperative and postoperative complications were recorded.

Results:

Indication for DMEK was Fuchs endothelial corneal dystrophy in 20 patients and pseudophakic bullous keratopathy in 5 patients. Mean BSCVA increased from 0,41 preopearatively to 0,78 at 1 month and to 0,96 at 6 months after DMEK when excluding patients with pre-existing ocular comorbidity. ECL was 29% and 32% 1 month and 6 month after DMEK respectively. There was intraoperative bleeding in anterior chamber recorded in one patient that was reabsorbed with intracameral injection of tissue plasminogen activator (TPA). There was one iatrogenic primary graft failure (first patient) and repeated DMEK was needed in 1 patient due to graft upside down.

Conclusions:

Endothelial keratoplasty can be safely performed with excellent visual outcomes when strating with DMEK without previous experience with other endothelial techniques like DSAEK.

Financial Disclosure:

None

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