Five-year clinical outcomes of 107 consecutive DMEK surgeries

PLOS ONE · 9 authors, 3 centres

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Limitations include the retrospective design and a relatively small sample size.

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Limitations include the retrospective design and a relatively small sample size. However, loss to follow-up was minimal (1% at 5 years). Findings were generally consistent with prior long-term DMEK studies.

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cohort

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ophthalmology

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AI pipeline

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ORIGINAL PAPER

PMC10735023

Five-year clinical outcomes of 107 consecutive DMEK surgeries

PLOS ONE

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ABSTRACT

Abstract Purpose The long-term clinical outcomes, postoperative complications, and graft survival of Descemet - membrane endothelial keratoplasty (DMEK) remain poorly understood. We retrospectively assessed these variables in all consecutive eyes that underwent DMEK for any indication in 2014–2018. The findings were compared to the long-term DMEK studies of five other groups (3–10-year follow-up). Methods Patients underwent ophthalmological tests preoperatively, at 1, 3, 6, and 12 postoperative months, and then annually. Five-year graft survival was determined by Kaplan-Meier estimator. Change in best-corrected visual acuity (BCVA), endothelial-cell density (ECD), and central-corneal thickness (CCT) at each timepoint was determined. Results 107 eyes (80 patients; 72 years old; 67% female) underwent first-time DMEK for uncomplicated Fuchs endothelial corneal dystrophy (94% of eyes), pseudophakic bullous keratopathy (3%), and regraft after previous keratoplasty (3%). The most common complication was graft detachment requiring rebubbling (18%). Thirteen grafts (12%) failed at ≤15 months. Cumulative 5-year graft-survival probability was 88% (95% confidence intervals = 79–94%). BCVA improved from 0.6 logMAR preoperatively to 0.05 logMAR at 1 year (p<0.0001) and then remained stable. Donor ECD dropped by 47% at 6 postoperative months and then continued to decrease by 4.0%/year. Five-year endothelial-cell loss was 65% (from 2550 to 900 cells/mm 2 ). CCT dropped from 618 to 551 μm at 5 years (p<0.0001). These findings are generally consistent with previous long-term DMEK studies. Conclusions DMEK has low complication and high graft-survival rates and excellent clinical outcomes that persist up to 5 years post-surgery. DMEK seems to be a safe and effective treatment in the long term.

CITATION EXPORT

Pierre Bichet, Rémi Moskwa, Christophe Goetz et al.. Five-year clinical outcomes of 107 consecutive DMEK surgeries. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0295434

AUTHORS

9 · 3 CENTRES

Pierre Bichet, Rémi Moskwa, Christophe Goetz, Yinka Zevering, Jean-Charles Vermion, Jean-Marc Perone, Timo Eppig, Timo Eppig, Timo Eppig

1Ophthalmology Department, Mercy Hospital, Regional Hospital Center (CHR) of Metz-Thionville, Metz, France
2Clinical Research Support Unit, Mercy Hospital, Regional Hospital Center (CHR) of Metz-Thionville Regional Hospital Center, Metz, France
3Saarland University, GERMANY