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Descemet Membrane Endothelial Keratoplasty in Aphakic, Aniridic, and Vitrectomized Eyes: A Review
Davide Romano1, Toshiki Shimizu2, Akira Kobayashi3
1Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Eye Clinic, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
Purpose:
The aim of this review is to examine the techniques, complications, and outcomes of Descemet membrane endothelial keratoplasty (DMEK) in aphakic, aniridic, and vitrectomized eyes.
Methods:
A literature search was conducted in the MEDLINE database (via PubMed), using as keywords "(DMEK) AND (aphakia OR aniridia OR vitrectomy OR vitrectomized)." The research was limited to 10 years (January 2014-March 2024), in view of lack of literature before 2014. Articles, including case reports and case series, were included.
Results:
Twenty articles were included. No randomized controlled trials were found nor comparative studies with more than 1 technique used. Mean rebubbling rate in complex eyes was 29%, whereas mean endothelial cell loss at 6 months was 37%. The mean postoperative visual acuity improved from 1.47 logarithm of the minimal angle of resolution to 0.7 logarithm of the minimal angle of resolution.
Conclusions:
Despite being more challenging, compared with the techniques reported in literature, DMEK can be considered a valid option for the management of endothelial decompensation in complex eyes, with rebubbling rate and endothelial cell loss at 6 months, which are similar to non-complex eyes.
