Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery

Schrittenlocher, Silvia, Grass, C., Dietlein, T., Lappas, A., Matthaei, M., Cursiefen, C. and Bachmann, B. . Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery. Graefes Arch. Clin. Exp. Ophthalmol.. NEW YORK: SPRINGER. ISSN 1435-702X

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DOI:10.1007/s00417-021-05506-4

Abstract

Purpose This study aims to assess the results, rebubbling rate, and graft survival after Descemet membrane endothelial keratoplasty (DMEK) with regard to the number and type of previous glaucoma surgeries. Methods This is a clinical retrospective review of 1845 consecutive DMEK surgeries between 07/2011 and 08/2017 at the Department of Ophthalmology, University of Cologne. Sixty-six eyes were included: group 1 (eyes with previous glaucoma drainage devices (GDD); n = 27) and group 2 (eyes with previous trabeculectomy (TE); n = 39). Endothelial cell loss (ECL), central corneal thickness, graft failure, rebubbling rate, and best spectacle-corrected visual acuity (BSCVA) up to 3 years after DMEK were compared between subgroups of patients with different numbers of and the two most common types of glaucoma surgeries either GDD or TE or both. Results Re-DMEK rate due to secondary graft failure was 55.6% (15/27) in group 1 and 35.9% in group 2. The mean graft survival time in group 1 was 25 +/- 11 months and 31.3 +/- 8.6 months in group 2 (p = 0.009). ECL in surviving grafts in group 1 was 35% (n = 13) at 6 months, 36% at 12 months (n = 8), and 27% (n = 4) at 2 years post-operatively. In group 2, ECL in surviving grafts was 41% (n = 10) at 6 months, 36% (n = 9) at 12 months, and 38% (n = 8) at 2 years postoperatively. Rebubbling rate in group 1 was 18.5% (5/27) and 35.9% (14/39) in group 2 (p = 0.079). Conclusion Eyes with previous GDD had no higher risk for an increased rebubbling rate but a higher risk for a re-DMEK due to secondary graft failure with a mean transplant survival time of about 2 years. Compared to eyes with preexisting glaucoma drainage device, eyes after trabeculectomy had less secondary graft failures and a longer mean graft survival rate.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Schrittenlocher, Silvia	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Grass, C.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Dietlein, T.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Lappas, A.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Matthaei, M.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Cursiefen, C.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Bachmann, B.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED