Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty Using a Preloaded Imported Graft
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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.
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.
참고문헌 (19)
- Price MO, "EK (DLEK, DSEK, DMEK): new frontier in cornea surgery", Annu Rev Vis Sci, 3, pp.69~90 (2017)
- Godinho JV, "Update on Descemet membrane endothelial keratoplasty", Curr Opin Ophthalmol, 30, pp.271~274 (2019)
- Yum HR, "Retrocorneal membrane after Descemet membrane endothelial keratoplasty", Cornea, 32, pp.1288~1290 (2013)
- 손우영, "전층각막이식술 후 이식편 실패가 온 환자에서의 데스메막내피각막이식술", 대한안과학회지, 62(6), pp.848~854 (2021), 대한안과학회
- Jung YH, "Clinical outcome of Descemet membrane endothelial keratoplasty(DMEK)with imported donor corneas in eyes of Asian patients : endothelium-in versus endothelium-out method", PLoS One, 17, pp.e0270037~ (2022)
- Hayashi T, "Techniques for learning descemet membrane endothelial keratoplasty for eyes of Asian patients with shallow anterior chamber", Cornea, 36, pp.390~393 (2017)
- Newman LR, "Preloaded Descemet membrane endothelial keratoplasty donor tissue : surgical technique and early clinical results", Cornea, 37, pp.981~986 (2018)
- 한겨레, "데스메막 각막내피이식술 후의 1년 임상결과", 대한안과학회지, 56(10), pp.1489~1496 (2015), 대한안과학회
- Birbal RS, "Five-year graft survival and clinical outcomes of 500 consecutive cases after Descemet membrane endothelial keratoplasty", Cornea, 39, pp.290~297 (2020)
- Vasiliauskaite I, "Descemet membrane endothelial keratoplasty : ten-year graft survival and clinical outcomes", Am J Ophthalmol, 217, pp.114~120 (2020)
- Price MO, "Descemet’s membrane endothelial keratoplasty : prospective multicenter study of visual and refractive outcomes and endothelial survival", Ophthalmology, 116, pp.2361~2368 (2009)
- Guerra FP, "Descemet’s membrane endothelial keratoplasty: prospective study of 1-year visual outcomes, graft survival, and endothelial cell loss", Ophthalmology, 118, pp.2368~2373 (2011)
- Gerber-Hollbach N, "Clinical outcome of rebubbling for graft detachment after Descemet membrane endothelial keratoplasty", Cornea, 36, pp.771~776 (2017)
- Chaurasia S, "Descemet’s membrane endothelial keratoplasty : clinical results of single versus triple procedures(combined with cataract surgery)", Ophthalmology, 121, pp.454~458 (2014)
- Feng MT, "Air reinjection and endothelial cell density in Descemet membrane endothelial keratoplasty : five-year follow-up", J Cataract Refract Surg, 40, pp.1116~1121 (2014)
- Chen C, "Viability of preloaded Descemet membrane endothelial keratoplasty grafts with 96-hour shipment", BMJ Open Ophthalmol, 6, pp.e000679~ (2021)
- Ham L, "Midterm results of Descemet membrane endothelial keratoplasty : 4 to 7 years clinical outcome", Am J Ophthalmol, 171, pp.113~121 (2016)
- Baydoun L, "Endothelial survival after Descemet membrane endothelial keratoplasty : effect of surgical indication and graft adherence status", JAMA Ophthalmol, 133, pp.1277~1285 (2015)
- Schlogl A, "Long-term clinical outcome after Descemet membrane endothelial keratoplasty", Am J Ophthalmol, 169, pp.218~226 (2016)