Outcomes Of Dmek For Endothelial Decompensation In Post- Dsaek Eyes

Published 2022 - 40th Congress of the ESCRS

Reference: FPM02.01 | Type: Free paper | DOI: 10.82333/ctwk-2078

Authors: Niccolò Salgari* ¹ , Davide Demaria ¹ , Marco Pellegrini ¹ , Rossella Spena ¹ , Cristina Bovone ¹ , Massimo Busin ¹

¹Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy

Purpose

To evaluate the outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with endothelial failure after Descemet stripping automated endothelial keratoplasty (DSAEK).

Setting

Tertiary Eye Care Referral Center (Ospedali Privati Forlì “Villa Igea”, Forlì, Italy)

Methods

Forty-four eyes of 44 patients that underwent DMEK for failed DSAEK were included. Graft failure was associated with signs of immunologic rejection in 13 of 44 eyes (29.5%). Main outcome measures were best corrected visual acuity (BCVA), endothelial cell loss (ECL), and graft failure.

Results

Compared to baseline, logMAR BCVA significantly improved from 1.56 ± 0.51 to 0.37 ± 0.36 at 1 year (p<0.001). ECL was 34%, 42% and 51% at 3, 6, 12 months, respectively. Graft failure occurred in 5 eyes (11%), all of which were due to progressive ECL with no signs of rejection.

Conclusions

Although associated with improved visual outcomes, DMEK in eyes with previous failed DSAEK grafts results in progressive and accelerated ECL with an increased risk of graft failure as early as 1 year postoperatively.