DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY (DMEK): CLINICAL OUTCOME OF THE FIRST 52 CONSECUTIVE CASES PERFORMED IN 2022 AND 2023

Descemet membrane endothelial keratoplasty (DMEK)

Keywords: corneal transplantation, corneal endothelial dysfunction, Descemet membrane endothelial keratoplasty (DMEK)

Abstract


Introduction/Objective: Corneal endothelial dysfunction is the most frequent indication for corneal transplantation in the developed countries. Shortly after its first appearance, Descemet membrane endothelial keratoplasty (DMEK) has been widely accepted due to its numerous advantages. Our aim is to report clinical outcome of DMEK in patients with dysfunction of corneal endothelium.

Material and method: We analyzed clinical outcome of DMEK of the first 52 consecutive cases. Parameters analyzed were as follows: best corrected visual acuity (BCVA), tomography, central corneal thickness, anterior segment optical coherent tomography (AS-OCT), and posterior segment OCT where needed. All parameters were measured before and up to six months after the surgery.

Results: DMEK was successful in 46 out of 52 eyes that underwent surgery. All eyes (100%) with good visual potential reached BCVA ≥ 20/40, and 57% reached ≥ 20/25. A partial graft detachment occurred in 8 eyes, which after repeated air injection into the anterior chamber resulted in graft reattachment and a clear cornea. Six eyes experienced primary graft failure which required second surgery.

Conclusion: Our series showed an excellent outcome of DMEK, concerning the rate of visual rehabilitation and potential serious complications. The main complication was an early partial graft detachment, which did not affect the final surgical outcome.

Author Biography

Zora Ignjatović, Milos Clinic Eye Hospital, Belgrade, Serbia

Professor of ophthalmology

References

Huertas-Bello M, Sabater AL, Koo EH. The Evolving Therapeutics of Endothelial Disease. Eye Bank Corneal Transpl. 2023 Sep;2(3):e0015. doi: 10.1097/ebct.0000000000000015.

Tourabaly M, Knoeri J, Georgeon C, Borderie V. Review of the Literature: Surgery Indications for Fuchs' Endothelial Corneal Dystrophy. J Clin Med. 2025 Mar 29;14(7):2365. doi: 10.3390/jcm14072365.

Melles GR, Lander F, Beekhuis WH, Remeijer L, Binder PS. Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy. Am J Ophthalmol. 1999 Mar;127(3):340-1. doi: 10.1016/s0002-9394(98)00324-9.

Melles GR, Ong TS, Ververs B, van der Wees J. Descemet membrane endothelial keratoplasty (DMEK). Cornea. 2006 Sep;25(8):987-90. doi: 10.1097/01.ico.0000248385.16896.34.

Melles GR, Ong TS, Ververs B, van der Wees J. Preliminary clinical results of Descemet membrane endothelial keratoplasty. Am J Ophthalmol. 2008 Feb;145(2):222-7. doi: 10.1016/j.ajo.2007.09.021.

van Dijk K, Ham L, Tse WH, Liarakos VS, Quilendrino R, Yeh RY, et al. Near complete visual recovery and refractive stability in modern corneal transplantation: Descemet membrane endothelial keratoplasty (DMEK). Cont Lens Anterior Eye. 2013 Feb;36(1):13-21. doi: 10.1016/j.clae.2012.10.066.

Flockerzi E, Turner C, Seitz B, Collaborators GSG; GeKeR Study Group. Descemet's membrane endothelial keratoplasty is the predominant keratoplasty procedure in Germany since 2016: a report of the DOG-section cornea and its keratoplasty registry. Br J Ophthalmol. 2024 May 21;108(5):646-53. doi: 10.1136/bjo-2022-323162.

Fu L, Hollick EJ. Rebubbling and graft detachment in Descemet membrane endothelial keratoplasty using a standardised protocol. Eye (Lond). 2023 Aug;37(12):2494-8. doi: 10.1038/s41433-022-02362-2.

Droutsas K, Giallouros E, Melles GR, Chatzistefanou K, Sekundo W. Descemet membrane endothelial keratoplasty: learning curve of a single surgeon. Cornea. 2013 Aug;32(8):1075-9. doi: 10.1097/ICO.0b013e31828f0e3c.

Published
2026/06/30
Section
Case series