Investigation Of Factors Affecting Endothelial Cell Density After Descemet Membrane Endothelial Keratoplasty
Published 2024 - 42nd Congress of the ESCRS
Reference: PO744 | Type: Free paper | DOI: 10.82333/701t-xf40
Authors: Hafize Gokben Ulutas* 1 , Büşra Yorulmaz 1
1Ophthalmology,Bursa City Hospital ,Bursa ,Türkiye
Purpose
To investigate preoperative, perioperative, and postoperative factors that may cause endothelial cell loss in patients undergoing Descemet membrane endothelial keratoplasty (DMEK).
Setting
Department of Ophthalmology, University of Health Sciences, Bursa City Hospital, Bursa, Turkey
Methods
The files of patients who had DMEK surgery between October 2021 and January 2023 were retrospectively examined. 36 eyes of 32 patients, 20 male and 12 female, were included in the study. The mean age was 67.2±2.1 (30-87) years. Preoperative and postoperative full ophthalmological examination findings and endothelial cell density (ECD) of the patients were recorded. The donor's age, ECD, and waiting time were recorded. The diameter, type, and unrolling time of the graft were determined from recorded surgical videos. Postoperative rebubbling was recorded.
Results
14 eyes were operated for Fuchs' dystrophy and 22 eyes were operated for pseudophakic bullous keratopathy. Eight (22.7%) eyes were phakic, and 28 eyes were pseudophakic. There was a history of previous vitrectomy in 8 eyes (22.2%). The average ECD in the donor cornea was 2819.67±317.34, and the ECD taken from the recipient cornea at the 6th postoperative month was 1711.91±208.96 (p<0.001). There was no relationship between ECD loss and donor age, waiting time, graft roll type, vitrectomized eye, surgery duration, and postoperative rebubbling. ECD loss was detected as 30.4% in phakic eyes and 40.8% in pseudophakic eyes (p=0.012). In tight grafts, the graft unrolling time was significantly longer (7.85±4.1 vs 4.02±2.6 min, p=0.006).
Conclusions
After DMEK, there is a high rate of ECD loss in the donor cornea. In this study, less cell loss was observed in phakic eyes than in pseudophakic eyes. No effect of perioperative and postoperative factors on cell loss in the graft was observed. To investigate the factors affecting ECD loss, a longer follow-up period and a larger number of samples are required.