Descemet Membrane Endothelial Keratoplasty (DMEK) Reduces the Corneal Epithelial Thickness in Fuchs’ Patients

Abstract

Fuchs’ endothelial corneal dystrophy (FECD) is the occurrence of corneal edema due to endothelial cell dystrophy. Descemet membrane endothelial keratoplasty (DMEK) is considered to be the gold standard of treatment. The aim of this study was to investigate the changes in the corneal epithelial thickness of FECD patients before and after DMEK and to compare these results with a healthy control cohort. In this retrospective analysis, 38 eyes of patients with FECD that were treated with DMEK and 35 healthy control eyes received anterior segment optical coherence tomography (OCT; Optovue, XR-Avanti, Fremont, CA, USA). The corneal epithelial thicknesses in different locations were analyzed and compared between the preoperative, postoperative, and control cohorts. The median follow-up time was 9 months. There was a significant degression of the mean epithelial thickness after DMEK in the central, paracentral, and mid-peripheral zones (p < 0.01) of the cornea. The total corneal thickness and stromal thickness decreased significantly as well. No significant differences were observed between the postoperative and control cohorts. In conclusion, the FECD patients had an increased epithelial thickness compared to the healthy controls, which decreased significantly after DMEK and reached thickness levels comparable to those of healthy control eyes. This study emphasized the importance of distinguishing between the corneal layers in anterior segment pathologies and surgical procedures. Moreover, it accentuated the fact that the structural alterations in FECD extend beyond the corneal stroma.

Selective Upregulation of Interleukin 1 Receptor Antagonist and Interleukin-8 in Fuchs’ Endothelial Corneal Dystrophy with Accompanying Cataract

“…Additionally, non-genetic factors such as UV exposure and smoking have been linked to FECD by increasing oxidative stress in corneal endothelial cells [5][6][7][8][9]. Currently, Descemet membrane endothelial keratoplasty (DMEK) is a gold standard for the FECD treatment [10,11].…”

Advancements in Bioengineering for Descemet Membrane Endothelial Keratoplasty (DMEK)

“…These may include a conservative therapy with hypertonic saline drops or ointments to reduce corneal edema and alleviate symptoms. However, corneal transplantation is currently the only effective treatment option for FECD patients in form of endothelial lamellar keratoplasty, especially Descemet Membrane Endothelial Keratoplasty (DMEK) to replace the damaged corneal endothelium with healthy donor tissue [32][33][34].…”