Descemet's membrane endothelial keratoplasty tissue type and endothelial cell loss over time

Abstract

Objective: To investigate endothelial cell loss after Descemet's membrane endothelial keratoplasty (DMEK) when surgery is performed with surgeon-loaded tissue versus preloaded tissue.

Methods: The endothelial cell count over time of patients who underwent the last DMEK surgery by a single surgeon with surgeon-loaded tissue from 2014-2017 was compared to that of patients who underwent the first DMEK surgery by different single surgeon with preloaded tissue from 2017-2020.

Results: Baseline characteristics, including age, sex, and baseline endothelial cell count of DMEK grafts, were not statistically different between the groups. Endothelial cell loss both immediately after surgery and continuing over a 4-year period after surgery was greater in the surgeon-loaded DMEK group compared to the preloaded DMEK group based on log-regression curve analysis. Endothelial cell loss was statistically significantly greater at 1 year, 2 years, 3 years, and 4 years after DMEK surgery with surgeon-loaded tissue compared to preloaded tissue on analysis of variance testing.

Conclusion: Preloaded DMEK tissue has significantly less endothelial cell loss both initially after surgery and over time compared to surgeon-loaded DMEK tissue, providing support for use of preloaded DMEK tissue for surgery.