Descemet membrane endothelial keratoplasty: analysis of clinical outcomes of patients with 8–10 years follow-up
Julia M. Weller, Friedrich E. Kruse, Theofilos Tourtas
Abstract
Abstract Purpose This study aimed to evaluate the clinical outcomes up to 10 years after Descemet membrane endothelial keratoplasty (DMEK). Methods In this retrospective, consecutive, single-center case series the medical files of eyes which have received DMEK between 2009 and 2012 for the treatment of endothelial dysfunction was evaluated regarding follow-up time and clinical outcomes. Annual examinations of best-corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT) of 66 eyes which fulfilled the criterion of a minimum of 8 years follow-up were analyzed. Results BCVA improved from 0.55 ± 0.37 logMAR ( n = 54) to 0.15 ± 0.11 ( n = 47) in eyes without ocular comorbidities one year after DMEK ( p < 0.001), and remained stable up to 10 years after DMEK. Mean ECD decreased to 744 ± 207 cells/mm 2 ( n = 39) after 9 years, and to 729 ± 167 cells/mm 2 ( n = 21) after 10 years, respectively. CCT decreased from 650 ± 67 μm before DMEK to 525 ± 40 μm ( n = 56) after 1 year, increasing slowly to 563 ± 40 µm ( n = 39) after 9 years, and to 570 ± 42 µm ( n = 21) after 10 years, respectively. Graft failure occurred in 4 of 66 eyes after year 8. These 4 eyes required repeat DMEK after 101–127 months. Conclusion This study shows the long-term outcomes in a small subset of DMEK grafts. Visual acuity remained stable in spite of slowly increasing corneal thickness and diminishing endothelial cell density during the 10-year period after DMEK.