Organ-cultured, prestripped donor tissue for DMEK surgery: clinical outcomes. Issue 8 (14th December 2016)

• Record Type: Journal Article
• Authors: Menzel-Severing, Johannes; Kruse, Friedrich E; Tourtas, Theofilos
• Is Part Of: British journal of ophthalmology. Volume 101:Issue 8(2017)
• Page Start: 1124
• Page End: 1127
• Publication Date: 2016-12-14
• Subjects: Cornea; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2016-309550
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : 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/mm 2 ; 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/mm 2 ; 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.