TY - JOUR
T1 - Parameters Associated With Endothelial Cell Density Variability After Descemet Membrane Endothelial Keratoplasty
AU - Oelrich, Silke
AU - Ham, Lisanne
AU - Frank, L.E.
AU - Gorges, Sandra
AU - Bourgonje, Vincent J.A.
AU - Baydoun, Lamis
AU - van Dijk, Korine
AU - Melles, Gerrit R.J.
PY - 2020/3
Y1 - 2020/3
N2 - PurposeTo evaluate which parameters may affect endothelial cell loss after Descemet membrane endothelial keratoplasty (DMEK) by comparing eyes in the low vs high quartile of endothelial cell loss over a follow-up period of 4 years.DesignRetrospective cohort study.MethodsDonor endothelial cell density (ECD) decline was evaluated for 351 eyes of 275 patients up to 4 years after DMEK for Fuchs endothelial corneal dystrophy (FECD). Eyes with a postoperative endothelial cell loss in the lower quartile at all available follow-up moments were assigned to Group 1 (n = 51) and those in the upper quartile to Group 2 (n = 42). Multinomial regression was used to assess which covariates were related to greater ECD decline.ResultsMean endothelial cell loss as compared to preoperative donor ECD for the entire study group was 33 (±16)%, 36 (±17)%, and 52 (±18)% at 1, 6, and 48 months postoperatively. Endothelial cell loss of Group 1 was 12 (±7)%, 13 (±6)%, and 26 (±8)% at, respectively, 1, 6, and 48 months postoperatively, and 59 (±10)%, 64 (±9)%, and 75 (±5)% in Group 2. Partial graft detachment, donor death cause cardiovascular/stroke (vs cancer), postoperative complications other than graft detachment, and severity of preoperative FECD (all P < .01) showed the strongest relation with greater ECD decline.ConclusionsDMEK eyes with a completely attached graft and operated in an early stage of FECD may show the lowest endothelial cell loss postoperatively.
AB - PurposeTo evaluate which parameters may affect endothelial cell loss after Descemet membrane endothelial keratoplasty (DMEK) by comparing eyes in the low vs high quartile of endothelial cell loss over a follow-up period of 4 years.DesignRetrospective cohort study.MethodsDonor endothelial cell density (ECD) decline was evaluated for 351 eyes of 275 patients up to 4 years after DMEK for Fuchs endothelial corneal dystrophy (FECD). Eyes with a postoperative endothelial cell loss in the lower quartile at all available follow-up moments were assigned to Group 1 (n = 51) and those in the upper quartile to Group 2 (n = 42). Multinomial regression was used to assess which covariates were related to greater ECD decline.ResultsMean endothelial cell loss as compared to preoperative donor ECD for the entire study group was 33 (±16)%, 36 (±17)%, and 52 (±18)% at 1, 6, and 48 months postoperatively. Endothelial cell loss of Group 1 was 12 (±7)%, 13 (±6)%, and 26 (±8)% at, respectively, 1, 6, and 48 months postoperatively, and 59 (±10)%, 64 (±9)%, and 75 (±5)% in Group 2. Partial graft detachment, donor death cause cardiovascular/stroke (vs cancer), postoperative complications other than graft detachment, and severity of preoperative FECD (all P < .01) showed the strongest relation with greater ECD decline.ConclusionsDMEK eyes with a completely attached graft and operated in an early stage of FECD may show the lowest endothelial cell loss postoperatively.
U2 - 10.1016/j.ajo.2019.10.017
DO - 10.1016/j.ajo.2019.10.017
M3 - Article
SN - 0002-9394
VL - 211
SP - 22
EP - 30
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -
