OUTCOMES OF DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY IN EYES WITH GLAUCOMA, MACULOPATHY, AND PREVIOUS CORNEAL TRANSPLANTS.

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP103 | Type: Abstracts | DOI: 10.82333/rr9n-ys50

Authors: Eleanor Ngwe Nche* ¹ , Ayala Katzir ¹ , Tomer Batash ¹ , Denise Wajnzstajn ¹ , Khaled Safadi ¹ , avraham Solomon ¹ , Itay Lavy ¹

¹Ophthalmology,HADASSAH MEDICAL CENTER,Jerusalem,Israel

Purpose

To report and analyze the outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) in eyes with corneal edema and associated ocular morbidities (glaucoma, maculopathy, and eyes after corneal transplants) in comparison to eyes without without.

Setting

Ophthalmology department of the Hadassah-Hebrew University Teaching Hospital, Jerusalem, Israel.

Methods

A retrospective study of seventy-seven (77) DMEK cases was done. Eyes after combined surgeries, vitrectomy, and eyes with AC IOL were excluded. Main outcome measures were Best Corrected Distance Visual Acuity (BCDVA) and graft survival. Eyes were separated into six groups as follows and analyzed: Glaucoma Only (GO), Glaucoma and Maculopathy (GMC), Glaucoma and previous Corneal transplant (GCT), previous Corneal Transplant (CT), Maculopathy Only (MO) and No associated glaucoma, maculopathy or corneal transplant (N).

Results

Overall, median BCDVA improved from 2.0 [0.2, 3] logMAR before surgery to 0.3 [-0.1, 2.0] logMAR 12 months after DMEK (p<0.001) with no difference between the groups at 1month, 3 months, 6 months and 12 months follow up times (p<0.05). Median BCDVA logMAR from before surgery improved significantly at 12 months in the N group; 1 [0.4, 3] to 0.2 [-0.1, 0.7] (p<0.001), CT group; 2 [0.2, 3] to 0.4 [0.1, 2] (p<0.01) and the GCT group; 2 [0.7,3] to 0.4 [0.2, 2] (p<0.05) but was not significant in the GO group; 1 [0.3, 3] to 0.3 [0.18, 2] (p>0.05), the MO group; 0.6 [0.2, 3] to 0.45 [0.1, 8] (p>0.05), and the GMC group; 1.0 [0.3,3] to 0.4 [0.1, 0.6] (p>0.05). Overall graft survival rate was 77.9% at 12 months. Highest in the N group (89.5%) and lowest in the GCS group (63.3%) (p=0.71).

Conclusion

DMEK offers visual rehabilitation in eyes with associated ocular morbidity. The least improvement in visual acuity is seen in patients with associated glaucoma, or maculopathy, or a combination of glaucoma and maculopathy. Eyes with glaucoma after previous corneal transplantation experience a significant improvement in vision at 12 months, but graft survival is 29% lower than in normal eyes.