DMEK Surgery at a Tertiary Hospital in Sweden. Results and Complication Risks

Area of Science:

• Ophthalmology
• Corneal Surgery
• Transplantation Science

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is an advanced endothelial keratoplasty technique.
• Understanding long-term clinical outcomes and graft survival is crucial for patient management and surgical planning.

Purpose of the Study:

• To evaluate the long-term clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) up to six years post-surgery.
• To assess visual acuity and endothelial cell density (ECD) changes over time following DMEK.

Main Methods:

• A cross-sectional, case series study design was employed.
• Data were collected from 162 eyes of 120 patients who underwent DMEK between 2013 and 2018.
• Inclusion criteria included DMEK-operated eyes without preoperative comorbidities, with follow-up ranging from 1 to 6 years.

Main Results:

• 85.8% of eyes without preoperative comorbidities achieved a visual acuity of 0.1 logMAR or better.
• Median endothelial cell density (ECD) loss increased progressively: 27% at 1-2 years, 31% at 2-3 years, 42% at 3-4 years, and over 60% at 4-6 years post-DMEK.
• Endothelial cell density was correlated with donor ECD and time since surgery.

Conclusions:

• Descemet membrane endothelial keratoplasty (DMEK) demonstrates promising visual outcomes in the medium term.
• Significant endothelial cell density loss over time raises questions about long-term graft sustainability.
• Further studies with extended follow-up are warranted to fully evaluate graft survival after DMEK.