M Satué1, M Rodríguez-Calvo-de-Mora2, M Naveiras3, J Cabrerizo4, I Dapena5, G R J Melles6. 1. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands; Hospital Universitario Miguel Servet, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España. 2. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Hospital Regional Carlos Haya, Málaga, España. 3. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Instituto Oftalmológico Fernández-Vega, Oviedo, España. 4. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Hospital Universitario de Álava, Vitoria, España. 5. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Hospital Universitario Príncipe de Asturias, Madrid, España. 6. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands. Electronic address: research@niios.com.
Abstract
OBJECTIVES: To evaluate the clinical outcome of the first 450 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK), as well as the effect of standardization of the technique. MATERIAL AND METHODS: Comparison between 3 groups: Group I: (cases 1-125), as the extended learning curve; Group II: (cases 126-250), transition to technique standardization; Group III: (cases 251-450), surgery with standardized technique. Best corrected visual acuity, endothelial cell density, pachymetry and intra- and postoperative complications were evaluated before, and 1, 3 and 6 months after DMEK. RESULTS: At 6 months after surgery, 79% of eyes reached a best corrected visual acuity of≥0.8 and 43%≥1.0. Mean preoperative endothelial cell density was 2,530±220 cells/mm2 and 1,613±495 at 6 months after surgery. Mean pachymetry measured 668±92 μm and 526±46 μm pre- and (6 months) postoperatively, respectively. There were no significant differences in best corrected visual acuity, endothelial cell density and pachymetry between the 3 groups (P > .05). Graft detachment presented in 17.3% of the eyes. The detachment rate declined from 24% to 12%, and the rate of secondary surgeries from 9.6% to 3.5%, from group I to III respectively. CONCLUSIONS: Visual outcomes and endothelial cell density after DMEK are independent of the technique standardization. However, technique standardization may have contributed to a lower graft detachment rate and a relatively low number of secondary interventions required. As such, DMEK may become the first choice of treatment in corneal endothelial disease.
OBJECTIVES: To evaluate the clinical outcome of the first 450 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK), as well as the effect of standardization of the technique. MATERIAL AND METHODS: Comparison between 3 groups: Group I: (cases 1-125), as the extended learning curve; Group II: (cases 126-250), transition to technique standardization; Group III: (cases 251-450), surgery with standardized technique. Best corrected visual acuity, endothelial cell density, pachymetry and intra- and postoperative complications were evaluated before, and 1, 3 and 6 months after DMEK. RESULTS: At 6 months after surgery, 79% of eyes reached a best corrected visual acuity of≥0.8 and 43%≥1.0. Mean preoperative endothelial cell density was 2,530±220 cells/mm2 and 1,613±495 at 6 months after surgery. Mean pachymetry measured 668±92 μm and 526±46 μm pre- and (6 months) postoperatively, respectively. There were no significant differences in best corrected visual acuity, endothelial cell density and pachymetry between the 3 groups (P > .05). Graft detachment presented in 17.3% of the eyes. The detachment rate declined from 24% to 12%, and the rate of secondary surgeries from 9.6% to 3.5%, from group I to III respectively. CONCLUSIONS: Visual outcomes and endothelial cell density after DMEK are independent of the technique standardization. However, technique standardization may have contributed to a lower graft detachment rate and a relatively low number of secondary interventions required. As such, DMEK may become the first choice of treatment in corneal endothelial disease.
Authors: M Tsatsos; V S Liarakos; C MacGregor; I Athanasiadis; E T Detorakis; M M Moschos; P Hossain; D F Anderson Journal: Eye (Lond) Date: 2017-04-21 Impact factor: 3.775
Authors: Natalia Vázquez; Manuel Chacón; Carlos A Rodríguez-Barrientos; Jesús Merayo-Lloves; Miguel Naveiras; Begoña Baamonde; Jose F Alfonso; Iriana Zambrano-Andazol; Ana C Riestra; Álvaro Meana Journal: PLoS One Date: 2016-12-01 Impact factor: 3.240
Authors: Maria Satue; Miriam Idoipe; Alicia Gavin; Maria Romero-Sanz; Vasilios S Liarakos; Antonio Mateo; Elena Garcia-Martin; Alejandro Blasco-Martinez; Antonio Sanchez-Perez Journal: J Ophthalmol Date: 2018-09-23 Impact factor: 1.909