Queratoplastia endotelial de membrana de descemet (DMEK): Resultados a dos años

Abstract

Purpose: To report the two-year results of Descemet membrane endothelial keratoplasty (DMEK) for managing corneal endothelial disorders. Methods: Non-randomized prospective clinical trial. A DMEK was performed in ten patients with Fuchs' endothelial dystrophy or bullous keratopathy. A 3.5 mm clear corneal incision was made and «under air» DM was stripped off from the posterior stroma. A 9.0 mm diameter, organ cultured donor DM roll was inserted into a recipient anterior chamber, positioned into the posterior stroma and secured by completely filling the anterior chamber with air for 30 minutes. Results: Three eyes showed complete detachment of the tissue; this was managed by a secondary Descemet stripping endothelial keratoplasty procedure. The remaining seven eyes had a best corrected visual acuity of > 0.7 in three eyes (43%) at one month, in five eyes (71%) at six months, and in six eyes (86%) at one and two years. At six months, the endothelial cell density averaged 2039 (±373) cells/mm2 (n=7), at one year 1925 (±267) cells/mm2 (n=7) and at two years 1730 (±400) cells/mm 2 (n=6). Conclusions: DMEK may provide quick and nearly complete visual rehabilitation. Since the donor tissue can be stripped from donor corneoscleral rims, the procedure may be readily accessible to most corneal surgeons.