Descemet membrane endothelial keratoplasty with or without overnight admission

To compare visual outcomes and show postoperative complication rates of Descemet Membrane Endothelial Keratoplasty (DMEK) with or without overnight admission.

Retrospective analysis of DMEK surgeries performed at the Royal Liverpool University Hospital from 2018 to 2023. Data on demographics, surgical details, intraoperative and postoperative complications and admission type were collected. Visual outcomes and complication rates of surgeries with or without overnight admission were evaluated.

344 eyes were included with mean patients' age of 72.1 ± 9.7 years (range 37.4-96.6 years). After surgery, 61.3% of patients (n = 211) were hospital-admitted for a one-night stay while 38.7% (n = 133) were home-discharged on the same day. Intraoperative complications occurred in 8.7% of patients and postoperative complications in 5.8%, with no difference with or without overnight admission (p = 0.308 and p = 0.412, respectively). There was no difference in the improvement in visual acuity (0.43 ± 0.6 and 0.45 ± 0.6 logMAR; range: -1.82; +2.38 logMAR) between both groups (p = 0.984), and no difference was found in postoperative rebubbling rate between both groups (30.8% in hospital-admitted and 31.6% in home-discharged; p = 0.926). Multivariate logistic regression showed no association between overnight admission and DMEK rebubbling rate (p = 0.555). However, postoperative complications, triple procedure and recipient age were all significant factors increasing DMEK rebubbling requirement (p < 0.05). Home-discharged patients had a risk ratio of 1.03 (95% CI 0.74-1.41; p = 0.926) for rebubbling and 0.68 (95% CI 0.28-1.372; p = 0.412) for postoperative complications compared to their hospital-admitted counterpart.

Visual outcomes and postoperative complications did not show any significant difference in DMEK surgeries with or without overnight admission.