Apparent Corneal Imbibition Pressure Elevation After Dmek For Fuchs Endothelial Corneal Dystrophy
Published 2025 - 43rd Congress of the ESCRS
Reference: PO519 | Type: Free paper | DOI: 10.82333/12bz-j896
Authors: Hilal Bayramoğlu* 1 , Burcu Yakut 2 , Feyza Önder 2
1Ophthalmology,Çorlu State Hospital,Tekirdağ,Türkiye, 2Ophthalmology,Haseki Training and Research Hospital,İstanbul,Türkiye
Purpose
To present potential explanations for the 'thinner than normal' pachymetry in post-Descemet membrane endothelial keratoplasty (DMEK) corneas.
Setting
Retrospective, interventional case series.
Methods
In a group of 324 eyes that underwent DMEK for Fuchs endothelial corneal dystrophy (FECD) or bullous keratopathy, pachymetry data were analyzed using preoperative pachymetry, percentage of pre- to postoperative corneal thinning, or modified Krachmer scale grading as input parameters for comparison (to avoid anatomical selection bias).
Results
Pachymetry changed from 514 (±45) mm at 3 months, to 533 (±40) mm 5-year after DMEK performed for FECD (n=302) (P<0.001); and in DMEK for bullous keratopathy (n=22) from 524 (±78) mm to 534 (±37) mm (P>0.99). A five-year return to a physiological pachymetry was seen for the subgroups with 1) a preoperative pachymetry of 600-650 mm and >650 mm, 2) all subgroups based on percentage of pre- to postoperative corneal thinning, and 3) a Krachmer scale grading 5 and 6 as input parameters (P<0.05).
Conclusions
Compared to physiological pachymetry values, post-DMEK FECD corneas were consistently found to be thinner. This finding may be explained by either a decrease in glycosaminoglycans volume (absolute 'underhydration' of the stromal glycosaminoglycans, i.e. corneal impaction), or an increased corneal imbibition pressure (relative 'underhydration' of the stromal glycosaminoglycans, i.e. 'corneal glaucoma').