AIM: To determine whether clinical performance is negatively affected by prestripping Descemet membrane endothelial keratoplasty (DMEK) grafts from organ-cultured corneas. METHODS: We reviewed clinical records of all patients who underwent DMEK surgery for Fuchs endothelial dystrophy between 28 October 2014 and 11 August 2015. Grafts had been prepared from organ-cultured corneoscleral buttons 24 hours prior to surgery or during surgery. We included only patients for which at least one follow-up examination was available at a minimum of 2 months postoperatively. MAIN OUTCOME MEASURES: best-corrected visual acuity (BCVA), central corneal thickness, endothelial cell count and rebubbling rates. RESULTS: Data given are mean±SD. No statistically significant differences were recorded at baseline between the partially stripped group (n=65) and the control group (n=72) with regard to donor age (70±9 vs 69±8 years; p=0.49), donor cornea endothelial cell density (2586±604 vs 2522±186 cells/mm2; p=0.6), BCVA (before DMEK: 0.77±0.5 vs 0.63±0.3 logMAR; p=0.27; before triple-DMEK: 0.56±0.2 vs 0.52±0.2 logMAR; p=0.33) or central corneal thickness (621±72 vs 607±53 μm; p=0.49). Mean follow-up was 149±83 versus 148±77 days; p=0.79. No statistically significant differences were observed between the two groups postoperatively with regard to BCVA (after DMEK: 0.25±0.2 vs 0.21±0.2 logMAR; p=0.59; after triple-DMEK: 0.22±0.2 vs 0.2±0.1 logMAR; p=0.98), central corneal thickness (502±42 vs 508±41 μm; p=0.47), endothelial cell count (1537±245 vs 1551±287 cells/mm2; p=0.65) and number of graft detachments requiring rebubbling (4.6% vs 9.7%; p=0.33). CONCLUSIONS: We found no evidence that the use of prestripped DMEK grafts is inferior to same-day preparation in organ-cultured corneas within the given follow-up. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
AIM: To determine whether clinical performance is negatively affected by prestripping Descemet membrane endothelial keratoplasty (DMEK) grafts from organ-cultured corneas. METHODS: We reviewed clinical records of all patients who underwent DMEK surgery for Fuchs endothelial dystrophy between 28 October 2014 and 11 August 2015. Grafts had been prepared from organ-cultured corneoscleral buttons 24 hours prior to surgery or during surgery. We included only patients for which at least one follow-up examination was available at a minimum of 2 months postoperatively. MAIN OUTCOME MEASURES: best-corrected visual acuity (BCVA), central corneal thickness, endothelial cell count and rebubbling rates. RESULTS: Data given are mean±SD. No statistically significant differences were recorded at baseline between the partially stripped group (n=65) and the control group (n=72) with regard to donor age (70±9 vs 69±8 years; p=0.49), donor cornea endothelial cell density (2586±604 vs 2522±186 cells/mm2; p=0.6), BCVA (before DMEK: 0.77±0.5 vs 0.63±0.3 logMAR; p=0.27; before triple-DMEK: 0.56±0.2 vs 0.52±0.2 logMAR; p=0.33) or central corneal thickness (621±72 vs 607±53 μm; p=0.49). Mean follow-up was 149±83 versus 148±77 days; p=0.79. No statistically significant differences were observed between the two groups postoperatively with regard to BCVA (after DMEK: 0.25±0.2 vs 0.21±0.2 logMAR; p=0.59; after triple-DMEK: 0.22±0.2 vs 0.2±0.1 logMAR; p=0.98), central corneal thickness (502±42 vs 508±41 μm; p=0.47), endothelial cell count (1537±245 vs 1551±287 cells/mm2; p=0.65) and number of graft detachments requiring rebubbling (4.6% vs 9.7%; p=0.33). CONCLUSIONS: We found no evidence that the use of prestripped DMEK grafts is inferior to same-day preparation in organ-cultured corneas within the given follow-up. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Annekatrin Rickmann; Karl Boden; Silke Wahl; Andre Trouvain; Andre Schulz; Peter Szurman Journal: Int Ophthalmol Date: 2021-10-21 Impact factor: 2.031