Universität zu Köln

Spaniol, Kristina, Hellmich, Martin, Borgardts, Klara, Girbardt, Christian, Maier, Philip, Reinhard, Thomas, Torun, Necip, Maier, Anna-Karina, Thaler, Sebastian, Bartz-Schmidt, Karl U., Wiedemann, Peter, Seitz, Berthold, Daas, Loay, Schrittenlocher, Silvia, Cursiefen, Claus, Bachmann, Bjoern and Geerling, Gerd (2023). DMEK outcome after one year - Results from a large multicenter study in Germany. Acta Ophthalmol., 101 (2). S. E215 - 11. HOBOKEN: WILEY. ISSN 1755-3768

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Abstract

Purpose Descemet membrane endothelial keratoplasty (DMEK) accounts for >50% of all corneal transplants in Germany. So far, no data from such a large multicenter study have been published. Methods This retrospective study included 3200 DMEKs at seven departments performed for Fuchs endothelial corneal dystrophy (FECD) or bullous keratopathy (BK). We evaluated best corrected visual acuity (BCVA, logMAR), endothelial cell density (ECD, cells/mm(2)), minimal corneal thickness (CT, mu m), rebubbling-, primary transplant failure- and immune reaction-rate. Changes over time were evaluated by linear mixed models for repeated measures and correlation with case number by center by weighted linear regression. Results For patients without vision-limiting comorbidities (74% of all analysed eyes, n = 2270), mean BCVA improved from 0.6 +/- 0.4 logMAR to 0.2 +/- 0.2 logMAR 6 months (p < 0.001, n = 1441) and 0.1 +/- 0.2 logMAR 12 months (p = 0.001, n = 1402) postoperatively. BK- had a worse BCVA compared to FECD-patients (0.3 +/- 0.5 vs. 0.1 +/- 0.2 logMAR [p < 0.001] at 1 year). ECD declined from 2465 +/- 259 cells/mm(2) (n = 2876 preoperatively) to 1587 +/- 433 cells/mm(2) after 12 months (p < 0.001, n = 1237). Mean rebubbling rate was 0.4 +/- 0.7/eye. 784 eyes (25%) received at least one rebubbling. More rebubblings correlated with a lower ECD, a worse BCVA, a higher CT, and higher transplant failure and rejection rates (p < 0.001, p = 0.013 for BCVA at 12 months). A single rebubbling did not influence the BCVA (p = 0.785). Graft failure rate was 3% (n = 67), rejection rate 1.5% (n = 48). Conclusion Descemet membrane endothelial keratoplasty increases visual acuity with low transplant failure- and rejection-rates. FECD has a better outcome than BK. Since a quarter of all patients need a rebubbling, this should be included in the informed consent. Remarkably, one rebubbling has no influence on the outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spaniol, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgardts, Klara UNSPECIFIED UNSPECIFIED UNSPECIFIED Girbardt, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinhard, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Torun, Necip UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Anna-Karina UNSPECIFIED UNSPECIFIED UNSPECIFIED Thaler, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bartz-Schmidt, Karl U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiedemann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Seitz, Berthold UNSPECIFIED UNSPECIFIED UNSPECIFIED Daas, Loay UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrittenlocher, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED Geerling, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-692886
DOI:	10.1111/aos.15257
Journal or Publication Title:	Acta Ophthalmol.
Volume:	101
Number:	2
Page Range:	S. E215 - 11
Date:	2023
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1755-3768
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEMBRANE ENDOTHELIAL KERATOPLASTY; GRAFT DETACHMENT; CORNEA; DLEK; DSEK Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69288