Comparison of clinical outcomes after precut DMEK with or without dextran-containing medium compared to standard DMEK: a prospective pilot study

Rickmann, Annekatrin; Boden, Karl; Wahl, Silke; Trouvain, André M.; Schulz, André; Szurman, Peter

doi:10.1007/s10792-021-02056-w

Cited by 2 publications

(1 citation statement)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The small sample size owing to the low popularity of DMEK surgery could have affected the statistical power. However, considering that other studies comparing two groups with similar sample sizes [ 40 , 42 , 55 ], the sample size of this study seems to be adequate to render a statistically sufficient power. Due to rarity of FED cases in Asia, inevitably, the indications for surgery have diversified.…”

Section: Discussionmentioning

confidence: 94%

Clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) with imported donor corneas in eyes of Asian patients; endothelium‐in versus endothelium‐out method

2022

View full text Add to dashboard Cite

Objective We investigated whether (1) imported pre-cut tissue is feasible for Descemet membrane endothelial keratoplasty (DMEK) in eyes of Asian patients, (2) the clinical outcome is comparable between the endothelium‐in and endothelium‐out methods, and (3) the corneal edema-induced anterior curvature changes may have an effect on the refractive error. Methods The medical records of 32 DMEK patients who underwent either the endothelium-out or endothelium-in method using imported pre-cut grafts with a 3-day pre-cut-to-use time were retrospectively analyzed. Fuchs’ endothelial dystrophy (37.5%) and bullous keratopathy (62.5%) cases were included. The main clinical outcome measures were graft survival, best corrected visual acuity (BCVA), endothelial cell density (ECD), corneal thickness (CT), and complications. Correlation of the anterior curvature changes with refractive error was analyzed in the DMEK with cataract surgery group. Results The overall survival rate was 71.9%. Final graft failures were caused by rejection, glaucoma, and infection. Visual acuities improved by 89.3%. BCVA better than 20/40 and 20/20 was found in 75% and 28.6% of patients, respectively. The ECDs at 3 months and 1 year were 1400 and 1083 cells/mm2, respectively. The mean survival time, ECD, BCVA, CT, and complication rates were not different between the endothelium-in and endothelium-out methods. A hyperopic shift by +0.42 D was not related to the anterior curvature changes. Conclusion Imported pre-cut tissues with a ≤ 3-day pre-cut-to-use time are feasible for DMEK in the treatment of corneal endothelial edema in eyes of Asian patients, and both endothelium-in and endothelium-out methods appear to be comparatively effective. Edema-induced anterior curvature change may not affect the refractive shift.

show abstract

Section: Discussionmentioning

confidence: 94%

Clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) with imported donor corneas in eyes of Asian patients; endothelium‐in versus endothelium‐out method

2022

View full text Add to dashboard Cite

show abstract

Descemet Membrane Endothelial Keratoplasty With and Without Graft Deswelling: A Prospective Clinical Study

Menzel-Severing,

Prues-Hölscher,

Jürgens

et al. 2024

Cornea

View full text Add to dashboard Cite

Purpose: The purpose of this study was to assess whether omission of dextran from corneal organ culture medium alters the outcome of Descemet membrane endothelial keratoplasty. Methods: Participation in this single-center, multisurgeon, prospective, randomized, comparative clinical trial was offered to patients scheduled for Descemet membrane endothelial keratoplasty between April 2020 and May 2022. Patients received grafts from corneas deswollen in organ culture medium-containing 6% dextran T-500 or from corneas that were not deswollen. Corrected distance visual acuity (CDVA), graft detachment, central corneal thickness (CCT), and corneal endothelial cell counts were measured at different time points up to 12 months postoperatively. Results: Grafts stored with dextran were transplanted in 92 patients, and grafts stored without dextran were transplanted in 102 patients. Mean donor age and endothelial cell counts did not differ significantly between both groups. Mean (±SD) postmortem time in hours was 23.9 ± 11.8 in grafts that were deswollen and 28.2 ± 13.8 in grafts that were not deswollen (P = 0.02). The groups did not show any significant difference at baseline regarding sex, CDVA, or CCT. In the group with dextran, patients had a mean age of 72.5 ± 9.9 years versus 69.5 ± 8.7 in the group without dextran (P = 0.03). CDVA improved and CCT decreased significantly in both groups. No differences were detected between the groups regarding CDVA, CCT, endothelial cell counts, or rebubbling rates. Conclusions: This study did not detect any evidence that the omission of dextran from organ culture medium negatively affects the outcomes of Descemet membrane endothelial keratoplasty.

show abstract

Comparison of clinical outcomes after precut DMEK with or without dextran-containing medium compared to standard DMEK: a prospective pilot study

Cited by 2 publications

References 37 publications

Clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) with imported donor corneas in eyes of Asian patients; endothelium‐in versus endothelium‐out method

Clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) with imported donor corneas in eyes of Asian patients; endothelium‐in versus endothelium‐out method

Descemet Membrane Endothelial Keratoplasty With and Without Graft Deswelling: A Prospective Clinical Study

Contact Info

Product

Resources

About