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Prescription patterns in DMEK: European survey.

Yexin Ye1, Fabio de Rooij, Nicolas Alejandre

  • 1From the University Eye Clinic, Maastricht University Medical Center+, Maastricht, the Netherlands (Ye, de Rooij, van den Biggelaar, Nuijts, Dickman); Ophthalmology Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain (Alejandre); Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of Strasbourg, Strasbourg, France (Bourcier); Ophthalmology Department, CHU Morvan, University Hospital of Brest, and University of Bretagne Occidentale (UBO), Brest, France (Cochener-Lamard); Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS, Foundation Trust, Newcastle Upon Tyne, United Kingdom (Figueiredo); Bioscience Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom (Figueiredo); Department of Cornea and Refractive Surgery, Instituto Oftalmológico Recoletas, Valladolid, Spain (Galarreta); Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark (Hjortdal); The Veneto Eye Bank Foundation, Venice, Italy (Jones); Dutch Transplant Foundation (NTS), Leiden, the Netherlands (Nathan); Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy (Romano); Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC) and Faculty of Medicine, University of Coimbra, Coimbra, Portugal (Rosa); Department of Ophthalmology, Saarland University Medical Centre, UKS, Homburg, Germany (Seitz); Department of Ophthalmology, Antwerp University Hospital, Edegem, and Brussels University Hospital VUB, Belgium (Tassignon); Eye Clinic, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Wacker); Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands (Dickman); Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, the Netherlands (Dickman).

Journal of Cataract and Refractive Surgery
|June 25, 2025
PubMed
Summary

European surgeons show varied Descemet Membrane Endothelial Keratoplasty (DMEK) prescription patterns, lacking standardized guidelines for infection, rejection, and glaucoma prevention. This highlights a need for evidence-based protocols in endothelial keratoplasty.

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Area of Science:

  • Ophthalmology
  • Cornea Surgery
  • Transplantation Medicine

Background:

  • Descemet Membrane Endothelial Keratoplasty (DMEK) is a modern endothelial keratoplasty technique.
  • Standardized prescription protocols for DMEK are not yet established across Europe.

Purpose of the Study:

  • To investigate current prescription patterns for Descemet Membrane Endothelial Keratoplasty (DMEK) in Europe.
  • To identify variations in medication use for preventing postoperative complications.

Main Methods:

  • A cross-sectional European survey was conducted among 136 surgeons.
  • Data were collected on medication protocols for infection, rejection, and pupillary block/glaucoma prevention in DMEK.

Main Results:

  • Medication protocols are primarily based on departmental guidelines or surgeon experience, not national standards.
  • Antibiotics and steroids are widely used for infection and rejection prevention, respectively.
  • Management of high-risk DMEK and steroid-induced hypertension varies, with increased topical steroids or immunosuppressants being common.

Conclusions:

  • Significant variability exists in current DMEK prescription patterns across Europe.
  • The lack of standardized guidelines influences diverse clinical practices in endothelial keratoplasty.