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Descemet Membrane Endothelial Keratoplasty

Lisanne Ham, MSc; Chandra Balachandran, MD; Christianne A. Verschoor, MSc; Jacqueline van der Wees, PhD; Gerrit R. J. Melles, MD, PhD

Arch Ophthalmol. 2009;127(3):252-255.

Objective  To evaluate visual rehabilitation after Descemet membrane endothelial keratoplasty (DMEK) in the management of corneal endothelial disorders.

Methods  In this prospective, nonrandomized, clinical study, DMEK was performed in a first group of 35 consecutive patients with either Fuchs endothelial dystrophy or bullous keratopathy. The Descemet membrane was stripped from the recipient posterior stroma with the anterior chamber completely filled with air. Using a 3.0-mm clear corneal incision, an organ-cultured donor Descemet roll 9 to 10 mm in diameter was inserted into the recipient anterior chamber, positioned on the posterior stroma, and secured by completely filling the anterior chamber with air for 45 to 60 minutes.

Results  Ten eyes had preexisting ocular disease or an early graft detachment. In the remaining 25 DMEK-treated eyes, best-corrected visual acuity was 20/40 (Snellen notation, 0.5) or more in 18 eyes (72%) within 1 month. At 3 months, best-corrected visual acuity was 20/40 (0.5) or more in 23 of 25 eyes (92%) and 20/25 (0.8) or more in 15 of 25 eyes (60%).

Conclusions  In most cases, DMEK results in functional visual rehabilitation within 1 to 3 months. Overall, visual recovery after DMEK may be faster and more complete than with other techniques for (lamellar) keratoplasty for treatment of corneal endothelial disorders.

Trial Registration  clinicaltrials.gov Identifier: NCT00521898

Author Affiliations: Netherlands Institute for Innovative Ocular Surgery (Mss Ham and Verschoor and Drs Balachandran, van der Wees, and Melles), Melles Cornea Clinic (Mss Ham and Verschoor and Dr Balachandran), and Amnitrans EyeBank (Drs van der Wees and Melles), Rotterdam, the Netherlands.

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