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Repeat DMEK yields positive visual outcomes
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Repeat Descemet’s membrane endothelial keratoplasty yielded acceptable visual acuity in the management of persistent graft detachment and graft failure, according to a study.
The retrospective case series included 550 eyes that underwent primary DMEK; 14 eyes underwent repeat DMEK for graft detachment and three eyes underwent repeat DMEK for endothelial graft failure.
An age-matched control group comprised a series of 17 uncomplicated DMEK procedures.
Investigators evaluated best corrected visual acuity, densitometry, endothelial cell density, pachymetry, and intraoperative and postoperative complications.
The average interval between primary and secondary DMEK was 16 months.
All repeat DMEK procedures were uneventful.
Six-month study group results showed that BCVA was 20/40 or better in 10 of 13 eyes (77%), 20/25 or better in five eyes (38%) and 20/20 or better in two eyes (15%).
At 12 months, BCVA was 20/40 or better in 12 of 14 eyes (86%), 20/25 or better in eight eyes (57%), 20/20 or better in three eyes (21%) and 20/17 or better in one eye (7%).
Five eyes were fitted with contact lenses to further improve BCVA.
Tertiary DMEK was performed in one eye.
Average donor endothelial cell density of second grafts was 2,580 cells/mm2 before surgery, 1,390 cells/mm2 at 6 months and 1,294 cells/mm2 at 12 months after repeat DMEK.
Pachymetry decreased from 703 µm before repeat DMEK to 515 µm at 6 months.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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