title: Long-term Clinical Outcome After Descemet Membrane Endothelial Keratoplasty.
abstract: To evaluate the long-term clinical outcome up to 5 years after Descemet membrane endothelial keratoplasty (DMEK).
  
  
  
  Retrospective, consecutive case series.
  
  
  
  In this single-center study, 310 consecutive DMEK operations for endothelial decompensation were reviewed; 97 eyes of 84 patients met the inclusion criterion of a minimum 3-year follow-up. Retrospective evaluation of clinical examinations occurred at 1 and 3 months and annually up to 5 years after DMEK at the Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen (FAU), Germany. Main outcome measures were corrected distance visual acuity (CDVA), endothelial cell density (ECD), central corneal thickness (CCT), and graft survival (Kaplan-Meier analysis).
  
  
  
  Mean follow-up was 53 ± 13 months. CDVA improved from 0.62 ± 0.42 logMAR before DMEK to 0.13 ± 0.12 logMAR (P < .001); 57% of eyes without ocular comorbidities reached ≥20/25 at 5 years after DMEK. ECD was stable after the initial postsurgical decrease (42% at 1 month, 44% at 5 years), from 2602 ± 243 cells/mm(2) before DMEK to 1460 ± 179 cells/mm(2) at 5 years. CCT decreased from 644 ± 67 μm before DMEK to 557 ± 49 μm at 5 years, with a minimum (530 ± 54 μm) at 3 months. Cumulative probability of 5-year graft survival was 95%.
  
  
  
  The long-term sustainability of DMEK was confirmed. DMEK not only provides fast visual rehabilitation but maintains its clinical outcome within a follow-up of 5 years. Visual acuity and endothelial cell loss remain stable between 3 months and 5 years after DMEK.
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schlögl
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Theofilos
authors.initials: T
authors.lastname: Tourtas
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Friedrich E
authors.initials: FE
authors.lastname: Kruse
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany. Electronic address: julia.weller@uk-erlangen.de.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Weller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*