Affiliation:
1. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands;
2. University Eye Hospital, Munster, Germany;
3. ELZA Institute Dietikon/Zurich, Switzerland;
4. Melles Cornea Clinic, Rotterdam, the Netherlands;
5. Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; and
6. Amnitrans EyeBank, Rotterdam, the Netherlands.
Abstract
Purpose:
The aim of this study was to assess the long-term clinical outcome, complications, and graft survival of bilateral Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy.
Methods:
This was a retrospective cohort study of 181 patients (362 eyes) with sequential bilateral DMEK for Fuchs endothelial corneal dystrophy. Clinical outcomes were assessed up to 5 years postoperatively. Outcome measures were best-corrected visual acuity, pachymetry, endothelial cell density, graft survival, and complication rates.
Results:
Contralateral DMEK was performed on average 15 ± 11 months (range: 2–60 months) after the first eye. From 1 until 5 years after DMEK, best-corrected visual acuity, pachymetry, endothelial cell density, and graft survival did not differ between the first and second eyes (all P > 0.05). Graft detachment occurred in 67 eyes (19% [18% first eyes, 19% second eyes], 6% bilateral), graft rejection in 9 eyes (3% [3% first eyes, 2% second eyes], 1% bilateral), glaucoma in 25 eyes (7% [8% first eyes, 6% second eyes], 2% bilateral), and graft failure in 22 eyes (6% [4% first eye, 8% second eye], 2% bilateral). All differences were not significant (all P > 0.05). Five-year graft survival rates were comparable for first and second eyes (0.95 and 0.92, respectively; P = 0.15).
Conclusions:
Clinical outcomes after bilateral DMEK are similar in both eyes and sustainable in the longer term. Within the first 5 years, the same complication may rarely occur in the contralateral eye.
Publisher
Ovid Technologies (Wolters Kluwer Health)