Descemet Membrane Endothelial Keratoplasty: Outcomes in the First Year of Experience

Abstract

Objectives: We aimed to report the clinical outcomes of Descemet membrane endothelial keratoplasty in our first year of experience.

Materials and Methods: Patients who underwent Descemet membrane endothelial keratoplasty at the Baskent University Faculty of Medicine, Department of Ophthalmology, between 2015 and 2016 were included in the study. Patient demographics, cause of endothelial dysfunction, best-corrected visual acuity, central corneal thickness, graft survival, follow-up duration, and intraoperative and postoperative complications were recorded.

Results: Five eyes of 5 patients (4 female, 1 male) with a mean age of 53.4 +/- 12.7 years were included. Cause of endothelial dysfunction included corneal endothelial dystrophy in 3 patients, pseudophakic bullous keratopathy in 1 patient, and endothelial graft failure after previous penetrating keratoplasty in 1 patient. Pre-stripped Descemet membranes obtained from the Ankara State Hospital Eye Bank were used. Mean duration of postoperative follow-up was 7.4 +/- 3.7 months. Mean preoperative Snellen best-corrected visual acuity and central corneal thickness were 0.24 +/- 0.15 and 625.5 +/- 97.4 mu m. Mean best-corrected visual acuity increased to 0.67 +/- 0.26 (P = .02) in the first month and to 0.84 +/- 0.11 (P < .01) at the end of follow-up. Mean central corneal thickness decreased to 546.6 +/- 28.4 pm (P = .03). Graft detachment was observed in 1 patient on the first postoperative day, and it was reattached successfully by injection of air into the anterior chamber. There were no intra-operative complications. All corneas were clear at the end of follow-up.

Conclusions: Descemet membrane endothelial keratoplasty provides a new and exciting option for endothelial transplant and has the potential to become the primary procedure for surgical management of Fuchs endothelial dystrophy and corneal endothelial disease. Rapid visual rehabilitation with few and manageable complications and good visual outcomes are the major advantages of this procedure.