Comparison of clinical outcomes after precut DMEK with or without dextran-containing medium compared to standard...

Area of Science:

• Ophthalmology
• Corneal Surgery
• Endothelial Keratoplasty

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure for endothelial dysfunction.
• Optimizing tissue preservation and surgical techniques for DMEK is crucial for patient outcomes.
• Precut DMEK offers potential advantages in surgical efficiency and tissue handling.

Purpose of the Study:

• To evaluate the clinical outcomes and complication rates of precut DMEK using two different storage media: dextran-containing and dextran-free.
• To compare these results against the standard DMEK procedure.

Main Methods:

• A prospective study involving 32 eyes with Fuchs endothelial dystrophy undergoing DMEK.
• Eyes were divided into four groups: precut DMEK in dextran-containing medium, precut DMEK in dextran-free medium, standard DMEK in dextran-containing medium, and standard DMEK in dextran-free medium.
• Follow-up was conducted for one year, assessing visual acuity, endothelial cell count, central corneal thickness, and rebubbling rates.

Main Results:

• All four groups demonstrated comparable clinical outcomes, including visual acuity, endothelial cell counts, and central corneal thickness.
• The rebubbling rates were similar across all study groups.
• No instances of graft failure were observed in any of the participants.

Conclusions:

• Precut DMEK, utilizing either dextran-containing or dextran-free organ culture medium, yields clinical results comparable to the standard DMEK procedure.
• These preliminary findings suggest that precut DMEK is a viable alternative with consistent outcomes.
• Further research may explore the long-term efficacy and broader application of precut DMEK techniques.