Five-year follow-up of corneal morphology and corneal refractive power changes after uneventful DMEK.

Abstract

To investigate changes of corneal thickness spatial profile (CTSP), corneal volume (CV) distribution, and total corneal refractive power (TCRP) over a course of 60months after uneventful Descemet membrane endothelial keratoplasty (DMEK). In our prospective, comparative study, sixty DMEK cases without intraoperative and postoperative complications and with complete 60-month follow-up were included (group 1). CTSP at corneal apex (CCT) and at 2mm, 4mm, 6mm, and 8mm rings, CV in 3mm, 5mm, 7mm, and 10mm zones, and TCRF in 2mm, 4mm 6mm, and 8mm zones were evaluated preoperatively and at 3, 6, 12, 24, and 60months postoperatively. The 60-month results were compared to an age-matched group of uncomplicated pseudophakic eyes (group 2; n = 20). The CCT and CTSP at 2, 4, and 6mm increased significantly at 60months compared to 3-month outcomes (P < 0.001). Similarly, CV increased significantly in 3mm, 5mm, and 7mm zones at 60months compared to 3months outcomes (P < 0.001). The TCRP showed in all zones a significant decrease at 3months (P < 0.001) followed by a continuous and significant increase at 60months (P < 0.001). The 60-month CCT and CTSP at 2mm were similar to group 2 (P ≥ 0.094). Sixty months after uneventful DMEK, CT within the central 2mm zone and CV at 3mm zone were similar to uncomplicated pseudophakic eyes. A continuous and statistically significant increase of TCRP was observed in all measured zonesafter the 3-month examination.