title: Ten-Year Clinical Outcome of the First Patient Undergoing Descemet Membrane Endothelial Keratoplasty.
abstract: OBJECTIVE
  To describe the 10-year clinical outcome of the first patient worldwide who underwent Descemet membrane endothelial keratoplasty (DMEK).
  
  
  METHODS
  In 2006, a 63-year-old man presented at the Melles Cornea Clinic, Rotterdam, with bilateral Fuchs endothelial dystrophy and cataract. After phacoemulsification, in vivo DMEK was performed in the left eye and 10 months later in the right eye. Best spectacle-corrected visual acuity (BSCVA), endothelial cell density, pachymetry, and complications were recorded every 6 months over a 10-year period.
  
  
  RESULTS
  BSCVA in the left eye improved from 20/60 (0.3) before surgery to 20/17 (1.2) at 1 month, and remained stable over 10 years, ranging from 20/20 (1.0) to 20/13 (1.5). BSCVA in the right eye improved from 20/50 (0.4) preoperative and 20/60 (0.3) at 1 month to 20/25 (0.8) at 3 months and 20/17 (1.2) at 6 months, ranging from 20/25 (0.8) to 20/17 (1.2) over 9 years. Both eyes underwent YAG-laser-capsulotomy to manage posterior capsule opacification at 5 and 4 years after DMEK, respectively. Endothelial cell density in the right and left eyes, respectively, decreased by 43% and 45% at 1 year, 52% and 59% at 5 years, and 72% and 68% at 10/9 years, respectively. No intraoperative or postoperative complications occurred; at the last follow-up, both corneas were clear.
  
  
  CONCLUSIONS
  The first DMEK patient worldwide may show all short and long-term characteristics of this endothelial keratoplasty technique: outstanding patient satisfaction, quick visual recovery, low incidence of complications, and graft longevity. Published studies in the past decade would suggest that this case was the start of a new era in corneal transplantation.
authors.affiliation: *Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands; and †Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands.
authors.forename: Lamis
authors.initials: L
authors.lastname: Baydoun
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Itay
authors.initials: I
authors.lastname: Lavy
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.forename: Marina
authors.initials: M
authors.lastname: Rodriguez-Calvo-de-Mora
authors.forename: Vasilios S
authors.initials: VS
authors.lastname: Liarakos
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D002386:Cataract / Q000150:complications / Q000628:therapy*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000473:pathology; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications / Q000601:surgery*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D064727:Posterior Capsulotomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*