The Open Ophthalmology Journal




ISSN: 1874-3641 ― Volume 12, 2018
RESEARCH ARTICLE

Outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) Using Surgeon’s Prepared Donor DM-Roll in Consecutive 100 Indian Eyes



Samar K Basak*, Soham Basak, Viraj R Pradhan
Cornea Department, Disha Eye Hospitals, Kolkata - 700120, India

Abstract

Background:

Descemet Membrane Endothelial Keratoplasty (DMEK) is now becoming the popular form of endothelial keratoplasty using only donor DM with healthy endothelium as true component lamellar corneal surgery.

Objective:

To analyze the results of visual outcomes, endothelial cell loss and complications of Descemet membrane endothelial keratoplasty in first consecutive 100 Indian eyes.

Methods:

100 eyes of 95 consecutive patients with endothelial dysfunctions of different etiologies scheduled for DMEK, were included in this study. In each case, surgeon prepared tissue using McCarey Kaufman medium- or Cornisol-preserved donor cornea with a cell count of ≥2500 cells/mm2. Surgical complications, Best Spectacle Corrected Visual Acuity (BSCVA); Endothelial Cell Density (ECD) and Endothelial Cell Loss (ECL) were analyzed for each patient after a minimum follow-up of three months.

Results:

The Main indication was pseudophakic corneal edema or bullous keratopathy in 52 (52%) eyes. 38 (38%) eyes had Fuchs′ dystrophy with various grades of cataract. In 43 phakic eyes, DMEK was combined with cataract surgery and intraocular lens implantation. Mean DM-roll preparation time was 7.5 ± 2.8 min and in 3 eyes, DM-graft were damaged. After 3-months, BSCVA was ≥20/25 in 57 (57.6%) cases. Mean ECD was 2123 ± 438/mm2 (range: 976 - 3208/ mm2) and the mean endothelial cell loss after 3-months was 26.92 ± 13.40 (range: 4.90 - 66.6%). Partial DM detachment occurred in 8 (8.0%) eyes and rebubbling required in 4 eyes. Iatrogenic primary graft failure occurred in one eye.

Conclusion:

Descemet membrane endothelial keratoplasty is a safe and effective procedure in several types of endothelial diseases among Indian patients with encouraging surgical and visual outcomes. Complications are less and endothelial cell loss percentage is acceptable.

Keywords: Visual Outcomes, Descemet Membrane Endothelial Keratoplasty, Surgeon’s prepared tissue, MK medium preserved-cornea, Cornisol-preserved cornea, Indian Eyes.


Article Information


Identifiers and Pagination:

Year: 2018
Volume: 12
Issue: Suppl-1, M2
First Page: 134
Last Page: 142
Publisher Id: TOOPHTJ-12-134
DOI: 10.2174/1874364101812010134

Article History:

Received Date: 05/06/2017
Revision Received Date: 23/08/2017
Acceptance Date: 19/10/2017
Electronic publication date: 23/07/2018
Collection year: 2018

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© 2018 Basaket al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author Cornea Department, Disha Eye Hospitals, Kolkata - 700120, India; Tel: 0091-3325452575; E-mail: basak_sk@hotmail.com


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