Indian journal of ophthalmology · 2025
Ten years of Descemet membrane endothelial keratoplasty: Identifying risk factors and early failure signs.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mechleb Nicole, Rizk Maria, Debellemanière Guillaume, Gatinel Damien, Saad Alain
Аннотация
PURPOSE: To evaluate the effect of surgical indications and complexity on long-term clinical outcomes in Descemet membrane endothelial keratoplasty (DMEK) and identify early signs of graft failure.
DESIGN: Retrospective case series of 105 patients who underwent DMEK from March 2012 to December 2014.
METHODS: Surgical results were analyzed at 1 year, 3 years, 5 years, and 10 years based on surgical indication: fuchs endothelial dystrophy (FECD) (n = 47) and bullous keratopathy (BK) (n = 58), and on the presence of anterior segment comorbidities: simple (n = 63) versus complex (n = 42) DMEK.
RESULTS: Fifty-two patients (54 eyes) were followed up for 3 years, 35 patients (42 eyes) reached the 5-year follow-up, and 20 patients (26 eyes) achieved the 10-year follow-up. Simple DMEK procedures and FECD demonstrated significantly better best corrected visual acuity (BCVA) compared to complex DMEK and BK at 1 year, 3 years, 5 years, and 10 years, respectively (P < 0.01). No statistically significant difference in endothelial cell density (ECD) decline was noted between simple and complex DMEK procedures, nor between FECD and BK (P > 0.05). Central and peripheral pachymetry were significantly higher in BK and complex surgeries at 10 years.
CONCLUSION: While DMEK represents a promising therapeutic avenue for corneal decompensation alongside anterior segment comorbidities, extended follow-up indicates a rise in central and peripheral pachymetry in comparison with simple DMEK. This increase could serve as an early indicators of corneal decompensation, potentially leading to reduced survival rates.
DESIGN: Retrospective case series of 105 patients who underwent DMEK from March 2012 to December 2014.
METHODS: Surgical results were analyzed at 1 year, 3 years, 5 years, and 10 years based on surgical indication: fuchs endothelial dystrophy (FECD) (n = 47) and bullous keratopathy (BK) (n = 58), and on the presence of anterior segment comorbidities: simple (n = 63) versus complex (n = 42) DMEK.
RESULTS: Fifty-two patients (54 eyes) were followed up for 3 years, 35 patients (42 eyes) reached the 5-year follow-up, and 20 patients (26 eyes) achieved the 10-year follow-up. Simple DMEK procedures and FECD demonstrated significantly better best corrected visual acuity (BCVA) compared to complex DMEK and BK at 1 year, 3 years, 5 years, and 10 years, respectively (P < 0.01). No statistically significant difference in endothelial cell density (ECD) decline was noted between simple and complex DMEK procedures, nor between FECD and BK (P > 0.05). Central and peripheral pachymetry were significantly higher in BK and complex surgeries at 10 years.
CONCLUSION: While DMEK represents a promising therapeutic avenue for corneal decompensation alongside anterior segment comorbidities, extended follow-up indicates a rise in central and peripheral pachymetry in comparison with simple DMEK. This increase could serve as an early indicators of corneal decompensation, potentially leading to reduced survival rates.