Descemet Membrane Endothelial Keratoplasty Performed With New Folding Insertion Technique: 1-Year Outcomes
Purpose
To describe clinical outcomes resulting from a new technique of Descemet’s membrane endothelial keratoplasty (DMEK) tissue introduction (folding technique).
Methods
A retrospective review of 43 consecutive eyes (41 patients) who underwent DMEK by the same surgeon was conducted from April 2012 until August 2014, using either a novel folding technique (n=29) or an insertion technique with an injector (n=14 eyes). Preoperative and postoperative best-corrected visual acuities at post-operative months 1, 3, 6, and 12 were recorded, as were the rates of graft detachment. Pre-operative endothelial cell density (ECD) measurements were compared to the post-operative ECD to determine the percentage of endothelial cell loss with both insertion techniques.
Results
Mean postoperative best-corrected visual acuities for the folding group at postop months 1, 3, 6, and 12 were 20/80, 20/30, 20/25, and 20/25 respectively, and for the injection group were 20/60, 20/30, 20/30, and 20/25 respectively. The rate of graft dislocation was 35% for the folding group and 57% for the injection group. Postoperative collection of ECD measurements is still ongoing. With results of 23 eyes available, mean percentages of endothelial cell loss for the two techniques were similar: 52±15% and 54±19% for the folding group (n=15) and the injection group (n=8) respectively.
Conclusion
Visual acuity outcomes, graft dislocation rates, and degree of endothelial cell loss appear comparable between the folding insertion technique and the injection technique.