Six-Month Results of Descemet Membrane Endothelial Keratoplasty in 100 Eyes: First Clinical Results from Turkey

OBJECTIVES: To evaluate the 6-month outcomes of Descemet membrane endothelial keratoplasty (DMEK) in patients with pseudophakic bullous keratopathy (PBK) and Fuchs’ endothelial dystrophy (FED) in a single center in Turkey. MATERIALS AND METHODS: The medical records of patients who underwent DMEK were reviewed retrospectively. Best corrected visual acuity (BCVA), donor corneal endothelial cell density (ECD), donor age, duration in solution after obtaining the donor tissue, and duration after exitus of the donor were evaluated preoperatively and BCVA, ECD, and ECD loss (%) at postoperative 6 months were evaluated postoperatively. Graft detachment, graft failure, and pupillary block were recorded as surgical complications. Patients with cataract and FED underwent combined or staged procedures. Two different graft preparation techniques were utilized: 8 and 9.5 mm. RESULTS: One hundred eyes of 74 patients were included in the study. Fifty-two of the eyes had FED and the remaining 48 had PBK. Mean ECD loss in 6 months was 29.2±4.4% in the FED group and 29.7±5% in the PBK group (p=0.415). Mean BCVA at 6 months was 0.06±0.05 in the patients with FED and 0.07±0.05 in the patients with PBK (p=0.378). Mean ECD loss in 6 months was 28.3±5.3% in the 8 mm group vs. 29.7±4.5% in the 9.5 mm group (p=0.255), and 28.5±5.6% in the combined group vs. 29.8±2.9% in the staged group (p=0.279). CONCLUSION: Different graft preparation techniques can be utilized with similar efficiency for DMEK surgery. A staged or combined approach can be used efficiently in the management of patients with FED and cataract. Our results are promising both for PBK and FED patients.