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DMEK, DSEK have similar graft survival rates in Fuchs’ endothelial corneal dystrophy
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Patients with Fuchs’ endothelial corneal dystrophy treated with either Descemet’s membrane endothelial keratoplasty or Descemet’s stripping endothelial keratoplasty experienced similar 5-year graft survival rates, according to a retrospective cohort study.
Researchers reviewed 2,017 consecutive cases performed by 13 surgeons between 2003 and 2012. The cases included 1,312 DSEK procedures and 705 DMEK procedures. They evaluated main outcomes measures of immunologic rejection episodes, graft failure or replacement, and endothelial cell loss.
“We found that DMEK and DSEK had similarly favorable 5-year survival rates (93%) when performed by experienced surgeons for the leading indication, Fuchs’ endothelial corneal dystrophy. The risk of graft failure from rejection was low with these procedures and not affected by donor sex, in contrast to widely publicized findings from the United Kingdom corneal graft registry with penetrating keratoplasty,” Marianne O. Price, PhD, a co-author of the study, told Healio.com/OSN.
The mean 5-year endothelial cell loss was 47% in DSEK patients and 48% in DMEK patients. The 5-year survival rate was 93% in both DMEK and DSEK. The 5-year survival rate with DSEK was 90% in the first 90 cases with manual donor dissection and 93% in the next 100 cases performed after changing to microkeratome dissection. The remaining 1,122 cases had a survival rate of 93%. In the DMEK cases, the 5-year survival rate in the first 200 cases was 89%, which improved to 95% in the subsequent cases. – by Robert Linnehan
Disclosures: David A. Price reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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