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Mid-term results of Descemet's membrane endothelial keratoplasty (DMEK): 2 to 6 year clinical outcome

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Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 09:20

Venue: Boulevard B

First Author: : L.Ham THE NETHERLANDS

Co Author(s): :    V. Liarakos   K. van Dijk   W. Tse   L. Baydoun   I. Dapena   G. Melles

Abstract Details


To evaluate the mid term outcomes of Descemet membrane endothelial keratoplasty (DMEK).


Retrospective study of non-randomized prospectively collected data at a tertiary referral center.


DMEK was performed in 300 consecutive eyes of 248 patients for Fuchs endothelial dystrophy, bullous keratopathy or previous corneal transplant failure. All eyes were followed regularly for at least 2 years (2-6 years). Best corrected visual acuity (BCVA), endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated before surgery, at 6, 12 and 24 months after DMEK and annually thereafter. Post-operative complications were described.


98.3% of eyes reached a BCVA of ≥20/40 (0.5), 78.7% ≥20/25 (0.8), 45.7% ≥20/20 (1.0) and 14.8% ≥20/17 (1.2) within the first 6 months after surgery, and remained stable up to 6 years. Donor ECD showed a decrease of 34.5% at 6 months and 42.8% at 2 years with an additional decrease of 8-10% per year up to 6 years. CCT decreased by 21.6% from 671µm (±99µm) before surgery to 525µm (±52µm) at 6 months and did not change thereafter. The most frequent complication was (partial) graft detachment observed in 14.7% (44/300) of cases, 11% (33/300) required a re-transplantation. The majority of complications appeared in the first 6 months, apart from allograft rejection episodes (2 out of 6 incidents needed re-transplantation), and late-onset graft failures (2 cases) that appeared 2 to 3 years later. Rebubbling rate was 4% (12/300).


Fast and near complete visual recovery achieved at 6 months remains stable for up to 2-6 years. Endothelial cell density decreases in a stable slow rate after the first 6 months. Complications are very rare after the first 6 months.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a competing company

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