Two-Year Clinical Outcome of 500 Consecutive Cases Undergoing Descemet Membrane Endothelial Keratoplasty

Purpose: To evaluate the clinical outcome of 500 consecutive cases up to 2 years after Descemet membrane endothelial keratoplasty (DMEK) and to assess which parameters may have influenced the clinical outcome. Methods: From a group of 500 eyes (393 patients), which underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), bullous keratopathy, failed corneal transplants and other indications, clinical outcomes [best-corrected visual acuity (BCVA), central endothelial cell density (ECD), and central corneal thickness] were evaluated before, and at 6, 12, and 24 months after DMEK and postoperative complications were documented. Results: At 12 months postoperatively, 81% of eyes reached a BCVA of ≥20/25 (≥0.8), 49% ≥20/20 (≥1.0), and 15% ≥20/18 (≥1.2) (n = 396) and remained stable up to 24 months (P = 0.828). Compared with preoperative ECD, mean postoperative ECD decreased by 37 (±18)%, 40 (±18)%, and 45 (±18)% at 6, 12, and 24 months, respectively (P
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research

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Conclusions: Epithelial ingrowth may occur after a corneal endothelium transplant. There have been multiple reports of epithelial ingrowth after Descemet stripping automated endothelial keratoplasty, but this particular case report suggests that epithelial ingrowth may also occur after DMEK. In this case, PK solved the complication.
Source: Cornea - Category: Opthalmology Tags: Case Report Source Type: research
ConclusionsBK was the first cause of keratoplasty with almost half of the cases, and keratoconus was relegated to sixth place with less than 5%. In comparison, in a study from eye banks from the US, BK was the second and keratoconus was the third indication for corneal grafts. The frequency of endothelial lamellar techniques in our institution decreased from 2012 to 2016. This could have been related to both the long time that the patients had to be on a waiting list, which made them unsuitable candidates for this technique, due to stromal fibrosis, and to the fact that surgeons of our institution had less experience with ...
Source: International Ophthalmology - Category: Opthalmology Source Type: research
Abstract Patients with gelatinous drop-like corneal dystrophy need to be effectively managed as the disease is severely debilitating in view of associated pho-tophobia and glare. Here, we report a rare case of gelatinous drop-like corneal dystrophy effectively managed by intraoperative anterior segment optical coherence tomography-guided manual deep anterior lamellar keratoplasty in 1 eye and sutureless fibrin glue-aided, microkeratome-assisted automated lamellar therapeutic keratoplasty in the other eye. The patient, a 22-year old man, presented with gradual diminution of vision associated with foreign body sensa...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
In this issue of JAMA Ophthalmology, Ang et al describe a prespecified secondary outcome of the Descemet Endothelial Thickness Comparison Trial (DETECT), a study designed to compare visual acuity outcomes from ultrathin Descemet stripping endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). The main and primary study outcome was that DMEK eyes saw 1.4 lines better than UT-DSAEK eyes at 12 months. Although visual acuity is the traditional functional measure of surgical success in ophthalmology, increasingly patient-reported outcomes, particularly those measuring vision-related quality o...
Source: JAMA Ophthalmology - Category: Opthalmology Source Type: research
Keratoconus is the most common corneal dystrophy in the Western world, frequently leading to severely impaired vision, most commonly in late childhood to early adulthood. Up to 25% of individuals with keratoconus will progress to a disease stage in which sharp visual acuity cannot be achieved anymore with vision correction and surgery is required. In recent years, corneal crosslinking (CXL) has become an established treatment to reduce the progression of keratoconus, thus eventually avoiding the need for corneal transplant. This underlines the importance of an early identification of patients at risk. The current clinical ...
Source: JAMA Ophthalmology - Category: Opthalmology Source Type: research
ConclusionStudy results suggest the similar trends in our tertiary care hospital as in other most advanced ophthalmic centers around the world for adoption of newer techniques of lamellar corneal transplants and their outcomes.
Source: Medical Journal Armed Forces India - Category: General Medicine Source Type: research
This study prospectively evaluated the use of ripasudil in patients undergoing DSO for FD. Methods: Enrolled patients underwent DSO with or without cataract surgery, performed by 1 surgeon. On the first postoperative day, patients were assigned to topical ripasudil 0.4% (Glanatec) 4 times a day for 2 months or no ripasudil and followed up monthly for the first 6 months and then at 9 and 12 months after surgery. Endothelial cell density (ECD) and pachymetry were evaluated at each postoperative visit. Results: Eighteen patients were enrolled, including 8 women and 1 man in each group. Overall, patients who underwent DS...
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research
CONCLUSIONS: Partial-thickness corneal transplants now account for 85% of all current graft procedures, and DMEK has emerged as the procedure of choice. Graft failure continues to be the leading indication for full-thickness grafts. Longitudinal studies are needed to determine whether these new trends persist and their future impact on graft failures. PMID: 30502981 [PubMed - in process]
Source: Canadian Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Can J Ophthalmol Source Type: research
This article presents a summary of the experiences of the past years collected at the Department of Ophthalmology at the University of Cologne. METHODS: A literature review of DMEK studies primarily from the Department of Ophthalmology at the University of Cologne, Germany was carried out. Own experiences in the fields of donor selection and graft preparation, DMEK surgery, complication management and postoperative treatment are summarized. RESULTS: Since the introduction of DMEK experience has been gained and ongoing improvements have occurred ranging from donor-recipient allocation to postoperative follow-...
Source: Der Ophthalmologe - Category: Opthalmology Authors: Tags: Ophthalmologe Source Type: research
Conclusion: Herein, we observed an increasing trend of endothelial pathology among keratoplasty indications as well as a major shift in preferred techniques due to a wide adoption of the new EK procedures. PMID: 30079255 [PubMed]
Source: Journal of Ophthalmology - Category: Opthalmology Tags: J Ophthalmol Source Type: research
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