Descemet membrane endothelial keratoplasty postoperative year 1 endothelial cell counts

Am J Ophthalmol. 2015 Mar;159(3):597-600.e2. doi: 10.1016/j.ajo.2014.12.008. Epub 2014 Dec 17.


Purpose: To report endothelial cell counts (ECC) in patients 1 year after Descemet membrane endothelial keratoplasty (DMEK) and suggest surgical techniques that may minimize intraoperative endothelial cell loss.

Design: Retrospective, observational case series.

Methods: This is a retrospective case series of 125 consecutive cases with 1 year of postoperative follow-up. Eight-millimeter DMEK grafts were prepared at a single institution via the submerged cornea, using backgrounds away technique. Grafts were introduced through a 2.4-mm incision and a "no-touch" technique was used to position them.

Results: The mean preoperative donor ECC was 2740 ± 210 (cells/mm(2)). Mean postoperative year 1 ECC was 2210 ± 550 for an ECC loss of 19% ± 10%. Rebubbling was performed in 5% of cases.

Conclusion: Postoperative year 1 endothelial cell counts in DMEK can equal and even surpass those of Descemet stripping automated endothelial cell keratoplasty (DSAEK) or even penetrating keratoplasty. Given reported decreased rejection rates in DMEK, these patients may have notably superior ECC 5 and 10 years out from surgery compared to if they had undergone DSAEK.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Cell Count
  • Corneal Endothelial Cell Loss / diagnosis*
  • Corneal Endothelial Cell Loss / prevention & control
  • Descemet Stripping Endothelial Keratoplasty*
  • Endothelium, Corneal / pathology*
  • Follow-Up Studies
  • Fuchs' Endothelial Dystrophy / surgery*
  • Graft Survival
  • Humans
  • Postoperative Period
  • Retrospective Studies
  • Tissue Donors