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Advisor(s)
Abstract(s)
Purpose: To determine predictive factors of higher levels of best-corrected visual acuity (BCVA) in the long-term after primary Descemet's membrane endothelial keratoplasty (DMEK). Methods: Retrospective, single-surgeon case series of 129 successful primary DMEK eyes without graft failure and with a minimum postoperative follow-up of 12 months. A mixed effect model for repeated measurements (MMRM) analysis was performed to determine recipient, donor, surgical, and postoperative factors associated with BCVA ≤ 0.10 logMAR (≥ 20/25 Snellen). Results: After primary DMEK, there was a statistically significant improvement in BCVA with a global reduction in logMAR BCVA (p < 0.00001). There was also a global tendency towards increasing the proportion of eyes with BCVA ≤ 0.10 logMAR at all time points (p < 0.00001), from 1.6% before DMEK to 64.4% in eyes with more than 5 years of F-U. The absence of retinal disease was associated with a decrease of 0.10 logMAR in postoperative BCVA after primary DMEK, maintaining constant the rest of the variables (p < 0.001). The variables age (OR 0.960), postoperative time (OR 1.083), preoperative BCVA ≥ 0.375 logMAR (OR 0.162), and indication for DMEK (OR 5.412) were included in the predictive MMRM model of BCVA ≤ 0.10 logMAR. Conclusion: Primary DMEK is associated with statistically and clinically significant improvement in BCVA that occurs early in the postoperative period and is continuous over time. Eyes with retinal comorbidities have an increased risk of worse postoperative BCVA after DMEK. Younger recipient age, Fuchs' dystrophy eyes, and eyes with better preoperative BCVA are more likely to achieve postoperative BCVA ≤ 0.10 logMAR.
Description
Keywords
Ophthalmology Descemet membrane Endothelial keratoplasty Predictors Visual acuity
Citation
Moura-Coelho N, Papa-Vettorazzi R, Dias-Santos A, Cunha JP, Dutra-Medeiros M, Manero F, et al. Predictive factors of long-term visual outcomes after primary Descemet's membrane endothelial keratoplasty (DMEK): retrospective study. Int Ophthalmol. 2024;44(1):430.
Publisher
Springer