Experience improves outcomes and reduces complications with DMEK

Jorge Peraza-Nieves MD Outcomes of Descemet’s membrane endothelial keratoplasty (DMEK) are good in the great majority of patients and get better as a surgeon gains experience with the technique, said Jorge Peraza-Nieves MD, Spain. “After an arbitrary learning curve of about 25 cases, intra- and postoperative complication rates may decrease. Notably, surgeons with a higher annual caseload may pass faster through their learning curve than surgeons performing their first surgeries over an extended period,” Peraza-Nieves told the 22nd ESCRS Winter Meeting. The retrospective, interventional cohort study involved 2,485 eyes undergoing DMEK, performed by 55 surgeons in 23 countries. The indications for surgery were Fuchs’ endothelial corneal dystrophy in 74%, bullous keratopathy in 17%, transplant failure in 8% or other indications in 1%. At six months’ follow-up, BCVA had improved in 90.5% of eyes, remained unchanged in 4.6% and deteriorated in 4.9%. In addition, BCVA was 20/40 or better in 75.4%, 20/25 or better in 45.4% and 20/20 or better in 25.8% for the entire group, with no eyes excluded because of low visual potential. The rates of both intraoperative and postoperative complications were significantly less common for surgeons who had performed more than 100 DMEK procedures than in those who had performed fewer than 100 or fewer than 25 procedures.

Tags: cornea, Belgrade 2018