Five-Year Safety and Efficacy of Femtosecond Laser-Assisted Descemet Membrane Endothelial Keratoplasty

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PURPOSE: The purpose of this study was to evaluate 5-year safety and efficacy outcomes of femtosecond-enabled Descemet membrane endothelial keratoplasty (F-DMEK) in patients with Fuchs' endothelial dystrophy (FED).

METHODS: This was a retrospective study, including patients with FED and cataract who underwent either F-DMEK (16 eyes of 15 patients) or manual DMEK (M-DMEK) (42 eyes of 37 patients) combined with cataract extraction. Outcome measures included visual acuity, graft detachment, graft survival, and endothelial cell loss.

RESULTS: The average follow-up in F-DMEK and M-DMEK was 57.1 ± 12.4 months and 58.5 ± 17.3 months, respectively ( P = 0.757). The rates of primary failure (0% vs. 9.5%, P = 0.567), secondary failure (0% for both), and graft rejection (0% vs. 7.1%, P = 0.533) did not differ significantly between the groups. Improvement in best spectacle-corrected visual acuity was similar in F-DMEK and M-DMEK (0.32 ± 0.27 logarithm of the minimum angle of resolution and 0.35 ± 0.44 logarithm of the minimum angle of resolution, respectively, P = 0.165) and persisted at 2, 3, 4, and 5 years and at the last follow-up. The rates of graft detachment and rebubbling were significantly lower with 6.25% in F-DMEK and 33.3% in M-DMEK ( P = 0.035). Cell-loss rates were lower in F-DMEK compared with M-DMEK throughout the follow-up, significantly so up to 2 years with a difference of 8.6% at 1 year ( P = 0.023), 11.8% at 2 years ( P = 0.021), 7.6% at 3 years ( P = 0.088), 5.8% at 4 years ( P = 0.256), 13.6% at 5 years ( P = 0.169), and 7.1% at the final follow-up ( P = 0.341).

CONCLUSIONS: F-DMEK had an excellent safety and efficacy profile which was maintained over 5 years of follow-up. Lower endothelial cell-loss rates in F-DMEK compared with M-DMEK may help extend the duration of graft survival.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:42

Enthalten in:

Cornea - 42(2023), 2 vom: 01. Feb., Seite 145-149

Sprache:

Englisch

Beteiligte Personen:

Sorkin, Nir [VerfasserIn]
Gouvea, Larissa [VerfasserIn]
Din, Nizar [VerfasserIn]
Mimouni, Michael [VerfasserIn]
Alshaker, Sara [VerfasserIn]
Weill, Yishay [VerfasserIn]
Gendler, Shai [VerfasserIn]
Slomovic, Allan R [VerfasserIn]
Chan, Clara C [VerfasserIn]
Rootman, David S [VerfasserIn]

Links:

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Journal Article

Anmerkungen:

Date Completed 02.01.2023

Date Revised 12.09.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1097/ICO.0000000000003019

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338796363