Official ESCRS | European Society of Cataract & Refractive Surgeons


Risk factors associated with high endothelial cell density decrease after Descemet's membrane endothelial keratoplasty (DMEK)

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Session Details

Session Title: Cornea Surgical: Lamellar Corneal Grafts

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 09:30

Venue: Free Paper Forum: Podium 3

First Author: : L.Baydoun THE NETHERLANDS

Co Author(s): :    L. Ham    S. Oellerich   K. van Dijk   L. Frank   S. Ní Dhubhghaill   G. Melles              

Abstract Details


To evaluate which parameters may affect endothelial cell density (ECD) decrease after Descemet membrane endothelial keratoplasty (DMEK) by comparing eyes in the low versus high quartile of ECD decrease over a follow-up period of four years.


Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.


For 351 eyes of 275 patients who underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), donor ECD decrease as compared to preoperative donor ECD was evaluated up to four years postoperatively. Eyes with a postoperative ECD decrease in the lower quartile at all available follow-up moments were assigned to Group 1 (n=51), and those in the upper quartile to Group 2 (n=42). Multinominal regression was used to assess which covariates were related to the different patterns of ECD decrease.


Mean ECD decrease for the entire study group was 33(±16)%, 36(±17)%, and 52(±18)% at 1, 6 and 48 months postoperatively, while at those time-points ECD decrease of Group 1 was 12(±7)%, 13(±6)%, and 26(±8)% and of Group 2 59(±10)%, 64(±9)%, and 75(±5)%. Partial graft detachment, donor death cause (cardiovascular/stroke vs cancer), postoperative complications other than graft detachment, and severity of preoperative FECD (all P<0.01) showed the strongest relation with different patterns of ECD decrease.


DMEK eyes with a completely attached grafts and operated in an early stage of FECD may show the lowest ECD decrease postoperatively.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company

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