Outcomes of Hemi-Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy
| Autor: | Korine van Dijk, Lamis Baydoun, Lisanne Ham, Isabel Dapena, Shugi Hsien, Vasiliki Zygoura, Rénuka S. Birbal, Gerrit R. J. Melles, Jack S. Parker |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Visual acuity genetic structures Descemet membrane Endothelium visual acuity Endothelial tissue Secondary Graft Failure Cell Count 03 medical and health sciences 0302 clinical medicine Postoperative Complications Descemet membrane endothelial keratoplasty Ophthalmology medicine Humans Prospective Studies Prospective cohort study Descemet Membrane Aged hemi-DMEK Aged 80 and over business.industry Endothelium Corneal Fuchs' Endothelial Dystrophy endothelial cell density Fuchs endothelial corneal dystrophy Corneal Endothelial Cell Loss Middle Aged eye diseases Endothelial cell density 030104 developmental biology medicine.anatomical_structure 030221 ophthalmology & optometry Female medicine.symptom business Fuchs Endothelial Corneal Dystrophy Descemet Stripping Endothelial Keratoplasty |
| Zdroj: | Cornea, 37(7), 854-858 |
| Popis: | PURPOSE To report the mid-term outcomes of hemi-Descemet membrane endothelial keratoplasty (hemi-DMEK) performed for Fuchs endothelial corneal dystrophy (FECD). METHODS In this prospective, interventional case series, we evaluated clinical outcomes of 10 eyes from 10 patients who underwent hemi-DMEK for FECD. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), central pachymetry, and postoperative complications. RESULTS At 1 year postoperatively, 7/7 eyes (excluding 2 eyes with low visual potential) reached a BCVA of ≥20/40 (≥0.5), 6/7 (86%) ≥20/25 (≥0.8), 4/7 (57%) ≥20/20 (≥1.0), and 2/7 (29%) 20/17 (≥1.2). BCVA remained stable until 2 years postoperatively (P ≥ 0.05) and further improved thereafter (P < 0.05). Mean ECD decreased from 2740 (±180) cells/mm preoperatively to 850 (±300) cells/mm (n = 9) at 1 year (P ≤ 0.05) and showed an annual decrease of on average 6% to 7% thereafter (P ≥ 0.05 between consecutive follow-ups). Pachymetry decreased from preoperatively 745 (±153) μm to 533 (±63) μm (n = 9) and 527 (±35) μm (n = 8) at 1 and 3 years postoperatively, respectively. Within the first 6 postoperative months, 4/10 eyes underwent rebubbling for visually significant graft detachment. One eye received secondary circular DMEK for persistent graft detachment 1 month postoperatively; another eye developed secondary graft failure 2.5 years postoperatively, and 1 eye was suspected for an allograft reaction 1.5 years postoperatively. CONCLUSIONS Hemi-DMEK may render visual outcomes comparable to those achieved by conventional DMEK. Despite low ECD counts by 6 months, ECD levels remain fairly stable thereafter. Hence, hemi-DMEK may become a potential alternative technique for treatment of FECD while increasing the yield of the endothelial tissue pool. |
| Databáze: | OpenAIRE |
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