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Twelve-year clinical outcome of the first patient undergoing bilateral true endothelial cell transplantation (Tencell), a preliminary form of Descemet�â�€�™s membrane endothelial keratoplasty (DMEK)

Poster Details

First Author: F.Sabatino UK

Co Author(s):    M. Tappin                    

Abstract Details

Purpose:

To report the twelve-year clinical outcomes following bilateral true endothelial cell transplantation (Tencell), a preliminary form of Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Ashford & St Peter's Hospitals NHS Foundation Trust, Ashford, United Kingdom

Methods:

Case report. In 2005, a 68-year-old man with Fuchs endothelial dystrophy underwent Tencell in both eyes. An 8 millimeter descemetorhexis was fashioned with a 27-gauge bent needle without the aid of any viscoelastic ophthalmic device or anterior chamber maintainer. Endothelium and Descemet�â�€�™s membrane were peeled from a 7.5-mm trephined sclerocorneal donor button and were inserted into the recipient�â�€�™s anterior chamber through an 8-mm two-stepped corneal incision with the aid of the Tappin�â�€�™s endothelial cannula. Twelve-year best spectacle-corrected visual acuity (BSCVA), endothelial cell count (ECC) and central corneal pachymetry (CCT) are reported.

Results:

Tencell transplant was clear in both eyes after twelve-years. In March 2017, BSCVA was 6/9 in right eye and 6/9 in left eye. CCT was 594 and 622 micrometers in right and left eye respectively. ECC was 1012 and 591 cells/mm2 in right eye and left eye respectively.

Conclusions:

Tencell transplantation represents a preliminary, successful attempt to selectively replace diseased endothelium and Descemet�â�€�™s membrane. It is technically challenging and intraoperative and postoperative complications represented the main limits for the wide-spread diffusion of this innovative technique. However, the long-term clinical outcomes hereby reported offer an historical interesting perspective of long-term survival of a DMEK variant.

Financial Disclosure:

NONE

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