Agudeza visual y densidad de células endoteliales tras queratoplastia endotelial de membrana de Descemet (DMEK) / Visual acuity and endothelial cell density following Descemet membrane endothelial keratoplasty (dmek)

Objetivo: Evaluación de los resultados visuales y de la densidad de células endoteliales en los 120 primeros ojos sometidos a queratoplastia endotelial de membrana de Descemet (DMEK) como tratamiento para la distrofia endotelial de Fuchs. Material y métodos: Se evaluaron los primeros 120 ojos sometidos a DMEK. En todos ellos se midió la agudeza visual mejor corregida (AVMC) antes y al 1, 3 y 6 meses después de la cirugía, así como la densidad celular endotelial (DCE) antes y a los 6 meses. Resultados: En los ojos con trasplante exitoso y sin patologías concomitantes (n=96), se observo una AVMC en el 77% de los casos al mes de la cirugía, en el 92% a los 3 meses y en el 95% a los 6 meses. La AVMC fue mayor o igual 0,8 en el 50%, 63% y 73% de los casos y mayor o igual 1,0 en el 23%, 34% y 45% al 1, 3 y 6 meses después de la cirugía, respectivamente. La DCE preoperatoria fue 2.610 (más menos,185) células/mm2 y 1.770 (más menos, 520) células/mm2 a los 6 meses postcirugía. En quince ojos se realizó una queratoplastia endotelial con pelado de la membrana de Descemet (DSEK) secundaria. En este grupo, el 91% de los pacientes alcanzó una AVMC mayor o igual 0,5, alcanzando solo uno de ellos una AVMC de 0,8 (n=11) a los 6 meses. Además, la DCE media fue de 2.580 (más menos, 185) células/mm2 antes y de 1.310 (más menos, 740) células/mm2 a los 6 meses de la operación (n=13). Conclusiones: DMEK permite una rápida y casi completa rehabilitación visual. La DCE postoperatoria observada es comparable al obtenido con técnicas precedentes de queratoplastia endotelial(AU)

Purpose: To assess the clinical outcomes of DMEK in the first series of 120 eyes operated for the treatment of Fuchs endothelial dystrophy in terms of visual acuity and endothelial cell density. Methods: The first 120 consecutive eyes that underwent DMEK (i.e. transplantation of an isolated donor Descemet membrane with its endothelium) were evaluated. In all eyes, the best corrected visual acuity (BCVA) before and at 1, 3 and 6 months after surgery, as well as the endothelial cell density (ECD) before and at 6 months were measured. Results: In eyes with a functional DMEK graft and good visual potential (n=96), the BCVA was major or equal 20/40 (major or equal 0.5) in 77% after 1 month, 92% after 3 months, and 95% after six months; major or equal 20/25 (major or equal 0.8) in 50%, 63%, and 73% of the cases, and major or equal 20/20 (major or equal 1.0) in 23%, 34%, and 45% of the cases at 1, 3, and 6 months respectively. In this group, ECD averaged 2610 (more less 185) cells/mm2 before, and 1770 (more less 520) cells/mm2 at six months after surgery (n=96). In 15 eyes, a secondary Descemet stripping endothelial keratoplasty (DSEK) was performed. In this group, 91% of patients reached a BCVA of major or equal 20/40 (major or equal 0.5) and only one patient achieved a BCVA of 0.8 at 6 months after surgery (n=11). Furthermore, ECD averaged 2580 (more less 185) cells/mm2 before and 1310 (more less 740) cells/mm2 at six months (n=13). Conclusion: DMEK provides a fast and high visual rehabilitation. Endothelial cell density loss may be similar to earlier types of endothelial keratoplasty(AU)

[Visual acuity and endothelial cell density following Descemet membrane endothelial keratoplasty (DMEK)]. / Agudeza visual y densidad de células endoteliales tras queratoplastia endotelial de membrana de Descemet (DMEK).

PURPOSE: To assess the clinical outcomes of DMEK in the first series of 120 eyes operated for the treatment of Fuchs endothelial dystrophy in terms of visual acuity and endothelial cell density. METHODS: The first 120 consecutive eyes that underwent DMEK (i.e. transplantation of an isolated donor Descemet membrane with its endothelium) were evaluated. In all eyes, the best corrected visual acuity (BCVA) before and at 1, 3 and 6 months after surgery, as well as the endothelial cell density (ECD) before and at 6 months were measured. RESULTS: In eyes with a functional DMEK graft and good visual potential (n=96), the BCVA was ≥ 20/40 (≥ 0.5) in 77% after 1 month, 92% after 3 months, and 95% after six months; ≥ 20/25 (≥ 0.8) in 50%, 63%, and 73% of the cases, and ≥ 20/20 (≥ 1.0) in 23%, 34%, and 45% of the cases at 1, 3, and 6 months respectively. In this group, ECD averaged 2610 (± 185) cells/mm(2) before, and 1770 (± 520) cells/mm(2) at six months after surgery (n=96). In 15 eyes, a secondary Descemet stripping endothelial keratoplasty (DSEK) was performed. In this group, 91% of patients reached a BCVA of ≥ 20/40 (≥ 0.5) and only one patient achieved a BCVA of 0.8 at 6 months after surgery (n=11). Furthermore, ECD averaged 2580 (± 185) cells/mm(2) before and 1310 (± 740) cells/mm(2) at six months (n=13). CONCLUSION: DMEK provides a fast and high visual rehabilitation. Endothelial cell density loss may be similar to earlier types of endothelial keratoplasty.