ESCRS - PP24.02 - Outcomes Of Preloaded Versus Surgeon Prepared Tri-Folded Endothelium-In Descemet Membrane Endothelial Keratoplasty

Outcomes Of Preloaded Versus Surgeon Prepared Tri-Folded Endothelium-In Descemet Membrane Endothelial Keratoplasty

Published 2023 - 41st Congress of the ESCRS

Reference: PP24.02 | Type: Free paper | DOI: 10.82333/tbpn-bq15

Authors: Linda Marie Louise Busin* 1 , Rossella Spena 2 , Angeli Christy Yu 2 , Marco Pellegrini 2 , Cristina Bovone 2 , Massimo Busin 2

1Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Forlì,Italy;Biomedical and Clinical Science ,Eye Clinic ''Luigi Sacco Hospital'',Milan,Italy, 2Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Forlì,Italy;Translational Medicine,University of Ferrara,Ferrara,Italy

Purpose

To compare the clinical outcomes of preloaded versus surgeon prepared tri-folded endothelium-in Descemet membrane endothelial keratoplasty (DMEK)

Setting

Ospedali Privati Forlì, "Villa Igea", Forlì, Italy

Methods

In this comparative, retrospective interventional case series, medical records of 69 cases of preloaded tri-folded endothelium-in DMEK from November 2016 to March 2018 were reviewed. The outcomes were compared with an age-matched control group (n=69) of surgeon prepared tri-folded endothelium-in DMEK surgeries. Main outcome measures were best spectacle-corrected visual acuity (BSCVA), endothelial cell loss and postoperative complication rates.

Results

Preoperative logMAR BSCVA was 0.97±0.63 in the preloaded DMEK group and 0.94±0.71 in the surgeon prepared DMEK group. At 6 months, both groups showed significant improvement in visual acuity (p<0.001). BSCVA did not differ significantly between both groups at all time points examined. In all eyes, DMEK surgery was uneventful. However, compared to surgeon prepared DMEK, mean endothelial cell loss was significantly higher in the preloaded DMEK group (p<0.001) Rebubbling rates did not differ significantly between the two groups.

Conclusions

Although visual outcomes and rebubbling rates of preloaded tri-folded endothelium-in DMEK are comparable to those of surgeon-prepared DMEK, use of preloaded grafts is associated with a higher rate of endothelial cell loss.