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Graft survival up to 7 years after descemet membrane endothelial keratoplasty: Effect of surgical indication and graft adherence status

Poster Details

First Author: L.Baydoun THE NETHERLANDS

Co Author(s):    L. Ham   V. Borderie   I. Dapena   L. Frank   S. Oellerich   G. Melles

Abstract Details

Purpose:

To determine graft survival probability and endothelial cell density (ECD) decay and their potential association with the indication for surgery and partial graft detachment, in the first cohort undergoing Descemet membrane endothelial keratoplasty (DMEK).

Setting:

The Melles Cornea Clinic: Tertiary referral centre

Methods:

353 primary DMEK eyes were prospectively evaluated up to 84 months after receiving DMEK for Fuchs endothelial dystrophy (FED, n=315), bullous keratopathy (BK, n=32) and failed previous endothelial graft (n=6); 315 eyes showed complete graft attachment and 38 eyes a partial graft detachment (≤1/3 of the graft surface area). Kaplan-Meier survival estimates were based on prospectively collected graft failures, and ECD was measured with specular microscopy. Main Outcome Measures were graft survival rates and ECD up to seven years after DMEK.

Results:

The overall graft survival rate was 96.1% at three years, and 95.1% at 5 and 7 years after DMEK. Graft failure occurred in 11 eyes (3.1%) within four years after DMEK. At 3 years, better survival rates were found in FED than BK eyes (97.7% vs. 78.2%, P=0.011), and in attached than partially detached grafts (96.9% vs. 90.7%, P=0.053), and the 5 year survival rate for attached vs. partially detached grafts was 95.7% vs. 90.7% (P=0.213). At 3 years, average ECD was higher in FED than BK eyes (P=0.003) and in eyes with attached than partially detached grafts (P=0.014).

Conclusions:

Promising graft survival rates and stable rates in ECD decrease up to 5 and 7 years after DMEK were found. Graft survival may vary with the indication for surgery and partial graft detachment. Particularly eyes operated on for FED and with completely attached grafts may have good prognosis after DMEK.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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