Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty (DMEK) Cases At A Tertiary Care Hospital In North India

Abstract

Abstract
Purpose: To analyze the clinical outcomes of DMEK in 200 cases. Methods: Prospective interventional study of cases of endothelial dysfunction (different etiologies) operated by a single surgeon. Endothelial Cell Density of the Donor cornea was > 2500 cells /mm2 and donor corneal scroll was prepared by surgeon at the time of surgery. Postoperative Best Corrected Visual Acuity (BCVA), Endothelial Cell Density and complications were analyzed till one year postoperatively. Results: The indications were Bullous Keratopathy in 128 eyes (64%), Previous Failed Graft in 36 (18%), Fuch’s endothelial corneal dystrophy (FECD) in 34 (17%) and Congenital Hereditary Endothelial Dystrophy (CHED) in 2(1%) cases. In phakic eyes with cataract 18 (9%), DMEK was combined with cataract surgery. BCVA of 6/6 was achieved in 8 (4%) eyes, 6/9 – 6/12 in 110 (55%) eyes, 6/18 – 6/36 in 53 (26.5%) eyes, 6/60 – 4/60 in 20 (10%) eyes and <3/60 in 9 (4.5%) eyes at the end of one year. Mean Endothelial Cell Density (ECD) decreased from 2674±158 (Before Surgery) to 2125±271 & 1940±275 at 6 months and 1 year respectively. The commonest complication was Descemet Membrane(DM) detachment in 22 eyes (11%) eyes of which 9 eyes required rebubbling. 4 eyes had primary graft failure. Conclusion: DMEK is a effective procedure in endothelial diseases with encouraging clinical outcomes & less complications .
Keywords: Clinical,outcome,hospital