DMEK Complications

Cornea. 2014 Jan;33(1):101-4. doi: 10.1097/ICO.0000000000000023.


Purpose: The aim of this study was to describe the incidence and management of the complications of Descemet membrane endothelial keratoplasty (DMEK) surgery performed by a single surgeon.

Methods: This is a retrospective case series. The clinical records of 72 consecutive patients (75 eyes) who underwent a DMEK with a minimum of 1-month postoperative follow-up were reviewed for adverse outcomes. The surgeon's first 50 operated eyes over a 4-month period were excluded from this study.

Results: All the eyes included were pseudophakic with endothelial failure resulting from either Fuchs dystrophy, pseudophakic bullous keratopathy, or a failed Descemet stripping automated endothelial keratoplasty. All the eyes had a total resolution of corneal edema. Donor tissue peeling was unsuccessful in 2 of 75 cases. Primary failure occurred in 2 of 75 cases; a repeated DMEK provided successful visual rehabilitation in both cases. Rebubbling was performed in 2 of 75 eyes, which was unsuccessful in both cases. Peripheral donor scrolls/contractions occurred in 17 of 75 eyes, and all were asymptomatic with 14 of 17 eyes (82%) located in the inferior quadrants. There were no cases of pupillary block glaucoma, inverted donors, or free-floating donors. Preliminary best spectacle-corrected visual acuity was 20/25 at postoperative month 3 with corresponding excellent endothelial counts (mean of 2112 cells per square millimeter in 22 patients with 6 months of follow-up).

Conclusions: The safety and rate of operative complications of DMEK are approaching that of Descemet stripping automated endothelial keratoplasty.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Corneal Endothelial Cell Loss / etiology
  • Descemet Membrane / surgery
  • Descemet Stripping Endothelial Keratoplasty / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity