Recipient endothelium may relate to corneal clearance in descemet membrane endothelial transfer.
OBJECTIVE
To describe corneal clearance after re-endothelialization of the recipient posterior stroma through Descemet membrane endothelial transfer (DMET) (ie, a "free-floating" donor Descemet graft in the recipient anterior chamber after descemetorhexis), in managing corneal endothelial disorders.


METHODS
Nonrandomized prospective study at a tertiary referral center.


METHODS
Twelve eyes enrolled in our study, 7 suffering from Fuchs endothelial dystrophy and 5 with bullous keratopathy. The clinical outcome was monitored by biomicroscopy, optical coherence tomography, confocal microscopy, endothelial cell density, and pachymetry measurements.


RESULTS
All eyes operated on for Fuchs endothelial dystrophy showed corneal clearance, with pachymetry values returning to normal (533 ±47 μm). The denuded recipient stroma re-endothelialized with an average endothelial cell density of 797 (± 743) cells/mm(2) at 6 months after surgery. In contrast, none of the bullous keratopathy eyes showed any improvement throughout the follow-up period.


CONCLUSIONS
DMET may be effective in the management of Fuchs endothelial dystrophy (primarily a Descemet membrane disorder), but not in bullous keratopathy (primarily an endothelial depletion). Apparently, the indication for surgery (ie, a "dystrophy" vs a "depletion" of recipient endothelial cells) relates to the capacity of the cornea to clear. This suggests that the remaining rim of recipient endothelium (after descemetorhexis) is involved in the re-endothelialization of the recipient posterior stroma after DMET.
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
Martin
M
Dirisamer
Ru-Yin
RY
Yeh
Korine
K
van Dijk
Lisanne
L
Ham
Isabel
I
Dapena
Gerrit R J
GR
Melles
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003315:Cornea / Q000502:physiology*; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D015715:Corneal Edema / Q000209:etiology / Q000503:physiopathology*; D003886:Descemet Membrane; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D033401:Microscopy, Acoustic; D018613:Microscopy, Confocal; D008875:Middle Aged; D011446:Prospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology