Korean J Ophthalmol.  2023 Oct;37(5):373-379. 10.3341/kjo.2023.0053.

Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty Using a Preloaded Imported Graft

• Kim M
• Kim KH
• Lee HK

• KMID: 2546488
• DOI: http://doi.org/10.3341/kjo.2023.0053

Abstract

Purpose
Although the popularity of Descemet membrane endothelial keratoplasty (DMEK) is increased, there is still few clinical studies in Korea. In this study, we aimed to report the initial clinical outcomes of DMEK in patients followed up for more than 6 months.
Methods
A total of 96 eyes that underwent DMEK by a single surgeon for Fuchs endothelial corneal dystrophy, pseudophakic bullous keratopathy, or other indications were evaluated for best-corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), postoperative complications, and graft survival.
Results
The postoperative BCVA significantly increased compared to the preoperative BCVA by 59.4% (1.00 ± 0.77 logarithm of the minimum angle of resolution vs. 0.67 ± 0.76 logarithm of the minimum angle of resolution, p < 0.001). The average preoperative ECD was 754 ± 382 cells/mm², increasing to 1,333 ± 562 cells/mm² at 3 months (76.8%, p < 0.001), 1,334 ± 632 cells/mm² at 6 months (76.9%, p < 0.001), 1,121 ± 474 cells/mm² at 12 months (48.7%, p = 0.024), and 972 ± 458 cells/mm² at 24 months postoperatively (28.9%, p = 0.445). Compared to 3 months, the ECD declined by 15.9% at 12 months (p = 0.009) and 27.1% at 24 months postoperatively (p = 0.158). The average CCT was 675 ± 113 μm preoperatively, decreasing to 581 ± 102, 574 ± 101, and 594 ± 94 μm at 6, 12, and 24 months after DMEK, respectively (p < 0.001 between all follow-up time points). Allograft rejection was detected in three (3.1%) and 14 eyes (14.6%) underwent retransplantation at an average of 10.1 ± 8.4 months after DMEK.
Conclusions
DMEK is promising for maintaining corneal clarity, low postoperative complication rates, and stable graft longevity.

Keyword

Descemet membrane endothelial keratoplasty; Descemet stripping automated endothelial keratoplasty; Endothelial keratoplasty