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Descemet's membrane endothelial keratoplasty (DMEK): first UK prospective study of 1-year visual outcomes, graft survival and endothelial cell count
  1. Robert A Reid,
  2. Ewan A Craig,
  3. Hanif Suleman
  1. Department of Ophthalmology, Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK
  1. Correspondence to Robert A Reid, Department of Ophthalmology, Shrewsbury and Telford Hospitals NHS Trust, Mytton Oak Road, Shrewsbury SY3 8XQ, UK; rareid67{at}yahoo.com

Abstract

Aim To evaluate the clinical outcomes of Descemet's membrane endothelial keratoplasty (DMEK) in the treatment of patients with Fuchs’ endothelial dystrophy.

Methods This prospective study involved 16 consecutive patients who had DMEK done and who were evaluated over a year. Measurements included best corrected visual acuity (BCVA), endothelial cell count, and central corneal thickness.

Results Two patients had failed grafts. Of the remaining 14 patients with successful grafts, after 12 months, 79% had BCVA of 6/6 or better, and all patients had a BCVA of 6/9 or better. Median endothelial cell count was 1567 cells per mm2 (range=900–2359) representing a 40% reduction compared with preoperative counts. Median central corneal thickness was 498 µm (range 445–567 µm) compared with a median of 649 µm (range 548–740 µm) preoperatively. All patients attained total visual rehabilitation without further surgical intervention.

Conclusions In our experience, DMEK has the potential to become the primary procedure for treating Fuchs’ endothelial dystrophy and endothelial disease as it produces rapid total visual rehabilitation with few complications, and an easy follow-up and management regimen. Donor preparation and graft insertion, however, remain important challenges.

  • Cornea
  • Dystrophy
  • Anterior chamber
  • Vision
  • Clinical Trial

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