Visual rehabilitation rate after isolated descemet membrane transplantation: descemet membrane endothelial keratoplasty.
OBJECTIVE
To evaluate visual rehabilitation after Descemet membrane endothelial keratoplasty (DMEK) in the management of corneal endothelial disorders.


METHODS
In this prospective, nonrandomized, clinical study, DMEK was performed in a first group of 35 consecutive patients with either Fuchs endothelial dystrophy or bullous keratopathy. The Descemet membrane was stripped from the recipient posterior stroma with the anterior chamber completely filled with air. Using a 3.0-mm clear corneal incision, an organ-cultured donor Descemet roll 9 to 10 mm in diameter was inserted into the recipient anterior chamber, positioned on the posterior stroma, and secured by completely filling the anterior chamber with air for 45 to 60 minutes.


RESULTS
Ten eyes had preexisting ocular disease or an early graft detachment. In the remaining 25 DMEK-treated eyes, best-corrected visual acuity was 20/40 (Snellen notation, 0.5) or more in 18 eyes (72%) within 1 month. At 3 months, best-corrected visual acuity was 20/40 (0.5) or more in 23 of 25 eyes (92%) and 20/25 (0.8) or more in 15 of 25 eyes (60%).


CONCLUSIONS
In most cases, DMEK results in functional visual rehabilitation within 1 to 3 months. Overall, visual recovery after DMEK may be faster and more complete than with other techniques for (lamellar) keratoplasty for treatment of corneal endothelial disorders.


BACKGROUND
clinicaltrials.gov Identifier: NCT00521898.
Ham
Lisanne
L
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
Balachandran
Chandra
C
Verschoor
Christianne A
CA
van der Wees
Jacqueline
J
Melles
Gerrit R J
GR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000601:surgery; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques; D011446:Prospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology*