Early Outcomes, Complications, Prognostic Factors And Cost Analysis Of Endoart In High-Risk Eyes: A 12 Month Single-Centre Audit From Moorfields Eye Hospital
Published 2026 - 44th Congress of the ESCRS
Reference: FP22.12 | Type: Free paper | DOI: 10.82333/s7zq-5306
Authors: Mr Kirupakaran Arun* 1 , Mr Ankit Sinha 1 , Mr Laurence Cox 1 , Mr Alfonso Perez 1
1Moorfields Eye Hospital,London,United Kingdom
Purpose
To evaluate outcomes, complications, healthcare utilisation, and prognostic factors influencing endoART attachment in eyes at high risk of graft failure and unsuitable for further corneal tissue transplantation.
Setting
Tertiary referral centre (Moorfields Eye Hospital NHS Foundation Trust, London, UK).
Methods
A retrospective audit was conducted of consecutive patients undergoing EndoART implantation at Moorfields Eye Hospital during the first year of service. All eyes were deemed at high risk of graft failure and unsuitable for further corneal graft transplantation. Primary outcomes were EndoART attachment at latest follow-up and requirement for rebubbling. Associations between potential prognostic factors and outcomes were assessed using Fisher’s exact test and Mann–Whitney U test, with significance set at p<0.05.
Results
Eleven eyes were included. At latest follow-up (median 9 months), EndoART attachment was achieved in 6/11 eyes (55%). Rebubbling was required in 9/11 eyes (median 2, range 1–5). Median best-corrected distance visual acuity remained unchanged (2.6 logMAR). Median central corneal thickness decreased significantly from 917.5µm to 540µm (p<0.01). Prior penetrating keratoplasty was associated with lower attachment rates (0/3 vs 6/8, p<0.06). Complications included one endophthalmitis and chronic detachment in three eyes. Postoperative utilisation was high (median 8 visits, 2 theatre episodes). EndoART was associated with higher total costs per eye (surgery and post-operative follow-up) than DSAEK (£2,950 versus £2,700).
Conclusions
In eyes at high risk of failure and unsuitable for further tissue-based keratoplasty, EndoART demonstrated acceptable early anatomical outcomes with significant corneal deturgescence but was associated with substantial postoperative intervention and healthcare utilisation. Visual acuity remained stable in this complex cohort. Previous penetrating keratoplasty may adversely affect EndoART attachment. Larger studies are required to further define prognostic factors and optimise patient selection.