Descemet’s membrane endothelial keratoplasty for pseudoexfoliation syndrome: a case series

Abstract

BackgroundTo evaluate the clinical outcomes and features of Descemet’s membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX).MethodsIn this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery about four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed.ResultsThis study included 14 eyes of 14 patients (PEX: n\xa0=\u20096, FECD: n\xa0=\u20098). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67\u2009±\u20090.28 at the preoperative point to 0.43\u2009±\u20090.14 at 1\u2009month, 0.27\u2009±\u20090.10 at 3\u2009months, and 0.19\u2009±\u20090.08 at 6\u2009months after DMEK. The donor corneal ECD was 2704\u2009±\u2009225 cells/mm2 at the preoperative point and decreased to 1691\u2009±\u2009498 cells/mm2 at 1\u2009month, 1425\u2009±\u2009366 cells/mm2 at 3\u2009months, and 1281\u2009±\u2009340 cells/mm2 (52.7\u2009±\u200911.7% less than ECD of the donor graft) at 6\u2009months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p\xa0=\u20090.821); BSCVA (p\xa0=\u20090.001) and the reduction rate of ECD (p\xa0=\u20090.010) were relatively worse.ConclusionsDMEK is effective for the treatment of endothelial dysfunction due to PEX.