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Preliminary outcome of hemi-Descemet membrane endothelial keratoplasty for Fuchs endothelial dystrophy

Poster Details

First Author: N.Gerber-Hollbach SWITZERLAND

Co Author(s):    J. Parker   L. Baydoun   V. Liarakos   L. Ham   I. Dapena   G. Melles

Abstract Details

Purpose:

To evaluate the clinical outcome of a full-diameter, untrephined, semi-circular Descemet graft in a consecutive series of Descemet membrane endothelial keratoplasty (hemi-DMEK), potentially allowing the harvesting of two grafts from a single donor corneo-scleral rim.

Setting:

Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.

Methods:

Interventional case series of ten eyes of ten patients with Fuchs endothelial cell density. Best corrected visual acuity (BCVA), endothelial cell density (ECD), and central corneal thickness (CCT) were evaluated up to six months postoperatively, and intra- and postoperative complications were recorded.

Results:

Hemi-DMEK was successful in nine out of ten eyes; one eye showed persistent graft detachment despite re-bubbling and underwent a secondary DMEK. BCVA improved in all successful hemi-DMEK eyes: at six months 100% of eyes (n=7) reached ≥20/40 (≥0.5), 86% (n=6) ≥20/25 (≥0.8) (Two eyes were excluded due to low visual potential). Average central ECD (n=9) declined from 2744 (±181) cells/mm2 preoperatively to 940 (±380) cells/mm2 at six months, with endothelial cell redistribution over bare stromal areas adjacent to the graft. Four eyes required re-bubbling for visually significant graft detachment. No other complications occurred throughout the study period.

Conclusions:

Hemi-DMEK may give visual outcomes similar to those in conventional DMEK. If ECD decrease and graft detachment rate would prove acceptable in larger series, hemi-DMEK could have the potential to double the availability of donor tissue for endothelial keratoplasty. FINANCIAL DISCLOUSRE: NONE

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