Endothelial cell density changes in the corneal center versus paracentral areas after DMEK
First Author: L.Ham THE NETHERLANDS
Co Author(s): A. Musayeva E. Livny D. Dragnea I. Vasiliauskaite S. Oellerich G. Melles
To analyze if endothelial cell density (ECD) differs between the central and paracentral areas after Descemet membrane endothelial keratoplasty (DMEK) and to identify locations of the highest and lowest ECD.
Retrospective, interventional case series conducted at the The Netherlands Institute for Innovative Ocular Surgery (NIIOS).
In this retrospective cohort study, central and paracentral ECD of 30 eyes (30 patients) who underwent DMEK for Fuchs endothelial corneal dystrophy were evaluated. Central, superonasal, superotemporal and inferior specular microscopy images were analyzed 1, 3, 6, 9 and 12 months after DMEK. Changes in ECD by location and over time were evaluated as well as changes in location for the highest and lowest ECD.
When compared with preoperative donor ECD, central ECD decreased by 32(±11)% at 12 months postoperatively. ECD decline between 1 to 12 months postoperatively in the central, inferior, superonasal and superotemporal location were 7%, 12%, 16%, and 13%, respectively (P<.0001 for all locations). Mean ECD was the highest in the center between the 3-12 months follow-up, while mean ECD was the lowest in the paracentral superonasal area at all time-points (P<.001). Mean ECD of the highest and lowest density location differed at all follow-up time-points (P<.003).
Postoperative ECD was not found to be uniform across the graft. Contrary to the density distribution in the normal endothelium, paracentral area ECDs were found to be consistently lower than in the central area. These differences were most prominent in the superonasal area and persisted 12 months postoperatively. Central ECD following DMEK might thus not represent an accurate proxy for cell density of the entire graft.