Existence Of Dark Spots May Be A Potential Risk Factor For Graft Failure In Descemet’S Membrane Endothelial Keratoplasty
Published 2024 - 42nd Congress of the ESCRS
Reference: PP16.12 | Type: Free paper | DOI: 10.82333/3zgg-rq16
Authors: Takahiko Hayashi* 1 , Ami Igarashi 2 , Masato Takeda 3 , Naoko Mashiko 4 , Toshiki Shimizu 2 , Kentaro Yuda 4 , Takefumi Yamaguchi 5 , Satoru Yamagami 2
1Ophthalmology,Nihon University,Tokyo,Japan;Ophthalmology,Nihon University,Tokyo,Japan, 2Ophthalmology,Nihon University,Tokyo,Japan, 3Ophthalmology,Yokohama Minami Kyosai Hospital,Yokohama,Japan, 4Ophthalmology,Kikuna Yuda Eye Clinic,Yokohama,Japan, 5Ophthalmology,Tokyo Dental College Ichikawa General Hospital,Ichikawa,Japan
Purpose
To investigate the risk factors for graft failure in Descemet’s membrane endothelial keratoplasty (DMEK).
Setting
This was a multicenter retrospective study conducted at the Yokohama Minami Kyosai Hospital and Kikuna Yuda Eye Clinic.
Methods
Patients who underwent DMEK by a single surgeon between January 2015 and July 2022 were enrolled in this study. Univariate and multivariate Cox regression models were used to explore the risk factors for graft failure using nine explanatory variables, including the presence of dark spots. We defined “dark spots” as intracellular discoloration on specular microscopy after corneal transplantation. To investigate the risk factors for graft failure in the dark spot group, univariate Cox regression models were applied using eight explanatory variables. ECD and central corneal thickness were summarized and compared between the groups with and without dark spots using the Wilcoxon rank-sum test.
Results
The study included 97 eyes of 97 patients who underwent DMEK, nine of which resulted in graft failure. Statistical analysis demonstrated that the presence of dark spots is a significant risk factor for graft failure. Univariate Cox regression models showed that the eight explanatory variables were not significant risk factors for graft failure in the group with dark spots. The presence of dark spots and status before and after COVID-19 vaccination had a significant impact on graft failure according to the multivariate Cox regression analysis (p = 0.046 and 0.042, respectively). The present study also found that the time course of ECD was lower in the group with dark spots.
Conclusions
This study demonstrated that the presence of dark spots is a significant risk factor for graft failure in DMEK. These findings may contribute to the identification of patients at higher risk of graft failure.