Descemet membrane endothelial keratoplasty: analysis of clinical outcomes of patients with 8–10 years follow-up

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.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10792-021-02176-3.