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Predictive factors of long-term visual outcomes after primary Descemet’s membrane endothelial keratoplasty (DMEK): retrospective study

2024-11Journal article Embargoed access
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dc.contributor.authorMoura-Coelho, Nuno
dc.contributor.authorPapa-Vettorazzi, Renato
dc.contributor.authorDias-Santos, Arnaldo
dc.contributor.authorCunha, João Paulo
dc.contributor.authorDutra-Medeiros, Marco
dc.contributor.authorManero, Felicidad
dc.contributor.authorGüell, José Luis
dc.date.accessioned2024-11-18T12:20:33Z
dc.date.embargo2026-11-18
dc.date.issued2024-11
dc.description.abstractPurpose: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMoura-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.pt_PT
dc.identifier.doi10.1007/s10792-024-03329-wpt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/17918
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.relation.publisherversionMoura-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.pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectOphthalmologypt_PT
dc.subjectDescemet membranept_PT
dc.subjectEndothelial keratoplastypt_PT
dc.subjectPredictorspt_PT
dc.subjectVisual acuitypt_PT
dc.titlePredictive factors of long-term visual outcomes after primary Descemet’s membrane endothelial keratoplasty (DMEK): retrospective studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage430pt_PT
oaire.citation.titleInternational Ophthalmologypt_PT
oaire.citation.volume44pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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