ESCRS - PO0664 - Learning Curve Of Intraoperative Donor Tissue Preparation And Dmek Surgery – First 86 Cases Of A Single Surgeon

Learning Curve Of Intraoperative Donor Tissue Preparation And Dmek Surgery – First 86 Cases Of A Single Surgeon

Published 2023 - 41st Congress of the ESCRS

Reference: PO0664 | Type: Free paper | DOI: 10.82333/mbdv-d823

Authors: Konstantinos Droutsas* 1 , Anastasia Tsiogka 1 , Dimitrios Spyropoulos 1 , Walter Sekundo 2 , Apostolos Lazaridis 3

1Ophthalmology,General Hospital of Athens ''Georgios Gennimatas'',Athens,Greece, 2Ophthalmology,Philipps University Marburg,Marburg,Germany, 3Ophthalmology,University of Magdeburg,Magdeburg,Germany

Purpose

Purpose of the current study is to analyze the first 86 DMEK cases of both graft preparation and surgery of a single surgeon.

Setting

Retrospective case series study

Methods

The present report includes the first DMEK cases performed by the same surgeon between 2010 and 2012.Donor preparation and DMEK surgery were performed in the operating theater successively. Best spectacle-corrected visual acuity, subjective refraction, Scheimpflug tomography, and endothelial cell density of the donor tissue were documented before and at 3, 6, 12 and 24 months after surgery; intraoperative and postoperative complications were recorded. The results of the early group (cases 1-43) and the late group (cases 44-86) were compared.

Results

Mean BCVA reached 0.7 (range: 0.05 to 1.0) at 24 months following DMEK. The main endothelial cell density reduction was observed at the 3rd postoperative month (35%). Average CCT was 550 μm (range 461 to 909μm) at the last follow up. There was no statistically significant difference between the early and the late group in terms of BCVA, CCT and ECD at any time point of the follow up period. Intraoperative complications were rare (0.99%), including air migration into the posterior chamber. The main postoperative complication was graft detachment (25.6%). The rebubbling rate decreased from 34.9 % in early group to 16.3% in the late group (p=0.048).

Conclusions

Our series showed very good results in terms of BCVA and ECD already in the first 43 DMEK cases of a single surgeon and no significant difference compared to the late 43 cases. However, the late group showed a significantly lower rebubbling rate compared to the early group indicating a considerable surgical skill improvement.