title: One year outcome of hemi-Descemet membrane endothelial keratoplasty.
abstract: OBJECTIVE
  To evaluate the 1-year clinical outcome after semi-circular Descemet membrane endothelial keratoplasty (hemi-DMEK) in a first case series.
  
  
  METHODS
  In three eyes of three patients with Fuchs endothelial dystrophy, best corrected visual acuity (BCVA), endothelial cell density (ECD), pachymetry, and intra- and postoperative complications were evaluated after transplantation of a semi-circular ~12 mm diameter Descemet graft (hemi-DMEK graft).
  
  
  RESULTS
  All corneas cleared within 6 months and showed a stable pachymetry thereafter (527, 535, and 490 μm, respectively). Compared to preoperative measurements, average central ECDs dropped by 51 % (56, 39, and 59 %, respectively) at 3 months, 53 % (57, 38, and 63 %, respectively) at 6 months, and 59 % (60, 47, and 71 %, respectively) at 12 months. Denuded stromal areas adjacent to the hemi-DMEK graft cleared and at 12 months peripheral ECD counts ranged from 724 to 1051 cells/mm(2). At 12 months, BCVA was 20/22 (0.9), 20/40 (0.5, amblyopic eye) and 20/17 (1.2). No postoperative complications occurred throughout the study period.
  
  
  CONCLUSIONS
  Hemi-DMEK may provide visual outcomes similar to those in standard DMEK at the 1-year postoperative mark. If also graft survival and complication rates prove to be similar, hemi-DMEK could become the next step in endothelial keratoplasty, owing to its potential to double the yield of transplants from the same donor pool (two hemi-DMEK grafts can be prepared from one donor cornea).
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Worthing and St Richard's Hospital, Western Sussex Hospitals NHS Foundation Trust, Worthing, UK.
authors.forename: Fook Chang
authors.initials: FC
authors.lastname: Lam
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands.|Amnitrans Eye Bank Rotterdam, Rotterdam, The Netherlands.
authors.forename: Lamis
authors.initials: L
authors.lastname: Baydoun
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Satué
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Allgemeines Krankenhaus Linz, Linz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Dirisamer
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands.|Amnitrans Eye Bank Rotterdam, Rotterdam, The Netherlands.
authors.forename: Lisanne
authors.initials: L
authors.lastname: Ham
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. research@niios.com.|Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands. research@niios.com.|Amnitrans Eye Bank Rotterdam, Rotterdam, The Netherlands. research@niios.com.
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D011446:Prospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
keywords: Descemet membrane endothelial keratoplasty; Endothelial cell density; Endothelial cell migration; Fuchs endothelial dystrophy; Hemi-DMEK; Visual acuity