Descemet's Membrane Endothelial Keratoplasty (DMEK)

Abstract

Introduction Our purpose was to report the clinical outcomes of Descemet's membrane endothelial keratoplasty (DMEK), at the postoperative 6th month. Patients and Methods Patients who underwent DMEK at Baskent University Faculty of Medicine, Department of Ophthalmology, between 2016 and 2017 were included in the study. Patient demographics, etiology of endothelial dysfunction, best corrected visual acuity, central corneal thickness, graft survival, intraoperative and postoperative complications and postoperative interventions were recorded. Results Six eyes of 6 patients (4 female, 2 male) with a mean age of 53.4±12.7 were included. Etiology of endothelial dysfunction was corneal endothelial distrophy in 3 patients, pseudophakic bullous keratopathy in 2 patients and endothelial graft failure after previous penetrating keratoplasty in 1 patient. Pre-stripped descemet’s membranes obtained from the Ankara State Hospital Eye Bank were used. Mean preoperative Snellen best corrected visual acuity (BCVA) and central corneal thickness (CCT) were 0.24±0.15 and 625.5±97.4 μm. Mean BCVA increased to 0.67±0.26 (p=.02) in the first month and to 0.84±0.11 (p<.01) at the end of the follow up. Mean CCT decreased to 546.6±28.4 μm (p=.03). Graft detachment was observed in 2 cases on the first and third postoperative days and the grafts were reattached succesfully by injection of air into the anterior chamber. There were no intraoperative complications. Five corneas were clear at the end of the follow-up. One patient had a re-DMEK and a following penetrating keratoplasty. Conclusions DMEK provides a new and exciting option for endothelial transplantation 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 managable complications and good visual outcomes are the major advantages of this procedure.