Following DMEK, majority of patients saw 20/40 or better with moderate endothelial cell loss

Ophthalmol. 2009;116(12):2361-2368.

Patients who underwent Descemet's membrane endothelial keratoplasty with donor corneas had good results following the procedure, a study found.

The prospective, multicenter, consecutive case series looked at 60 eyes of 56 patients who had Fuchs' endothelial dystrophy, pseudophakic bullous keratopathy or failed previous graft. Forty-eight patients underwent Descemet's membrane endothelial keratoplasty (DMEK), 11 patients had DMEK combined with phacoemulsification and lens implantation, and two patients had DMEK combined with pars plana vitrectomy.

At 3 months, best corrected visual acuity was 20/20 in 26%, 20/25 or better in 63% and 20/40 or better in 94% of participants. Refractive cylinder remained unchanged, and a hyperopic shift was noted in DMEK single procedures.

Descemet's membrane and endothelium were "stripped from donor corneas submerged in corneal storage solution in a corneal viewing chamber," according to the study. Following trypan blue staining, donor Descemet's membrane was inserted through a 2.8-mm incision.

The Descemet's membrane was successfully stripped from 60 of 72 donor corneas, with six converted to Descemet's stripping automated endothelial keratoplasty. Six were discarded.

One graft in the study detached completely, and 38 eyes required reinjected air.

"Five DMEK corneas (8%) failed to clear and were replaced successfully with DMEK or DSAEK. All remained clear at last follow-up," study authors said.