Midterm Results of Descemet Membrane Endothelial Keratoplasty: 4 to 7 Years Clinical Outcome
| Autor: | Isabel Dapena, Lisanne Ham, Gerrit R. J. Melles, Abbas Ilyas, Lamis Baydoun, Vasilis S. Liarakos, Korine van Dijk, Silke Oellerich |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Time Factors genetic structures Descemet membrane Corneal Pachymetry Visual Acuity Cell Count Corneal Diseases 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Corneal pachymetry Aged Netherlands Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Incidence (epidemiology) Incidence Endothelium Corneal Graft Survival Retrospective cohort study Middle Aged Confidence interval Surgery Endothelial cell density Ophthalmology Treatment Outcome 030221 ophthalmology & optometry Graft survival Female medicine.symptom business 030217 neurology & neurosurgery Descemet Stripping Endothelial Keratoplasty Follow-Up Studies |
| Zdroj: | American Journal of Ophthalmology, 171, 113-121 |
| ISSN: | 1879-1891 |
| Popis: | Purpose To evaluate the midterm outcomes of Descemet membrane endothelial keratoplasty (DMEK) up to 4–7 years postoperatively. Design Retrospective, consecutive interventional case series. Methods A total of 250 consecutive eyes of 209 patients who underwent DMEK at our institute and had potentially at least 4 years of follow-up. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), graft survival rate, and postoperative complications. Results At 6 months postoperatively, 73% of the eyes reached a BCVA of ≥20/25 (0.8) and 44% ≥20/20 (1.0), and remained stable up to 7 years ( P = .7114). ECD dropped by 33.9% in the first 6 months, and then declined by a yearly rate of 9.0%. CCT did not show a significant change after 6 months up to 7 years ( P = .8447). The cumulative graft survival rate at 4 and 7 years was 0.96 (95% confidence interval [0.93, 0.99]). Rebubbling procedures were performed in 4.4% of eyes, all within the first 6 postoperative months. Repeat transplantations were performed in 15.2% of cases to manage greater than one third graft detachment (11.6%), primary graft failure (1.6%), or secondary graft failure (2.0%), with the majority (79%) of repeat transplantations performed within the first year. After 6 months, the main complications were allograft rejection (2.4%) and secondary graft failure (2.0%). Conclusions The visual acuity level achieved at 6 months after DMEK may remain stable up to at least 4–7 years; ECD shows a constant, slow decrease; and complications after the first 6 months occur in |
| Databáze: | OpenAIRE |
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