Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion

Figures & data

Table 1 Demographic And Clinical Characteristics Of The Full Cohort

	All DMEK (n = 24)
Donor characteristics
Donor age, mean ± SD [years]	64.4 ± 5.6
Sex
Female, No. (%)	10 (41.7)
Male, No. (%)	14 (58.3)
Race
Caucasian, No. (%)	20 (83.3)
Asian, No. (%)	1 (4.2)
Hispanic, No. (%)	2 (8.3)
Unknown, No. (%)	1 (4.2)
Graft diameter, mean ± SD [mm]	8.0 ± 0
Death to preservation time, mean ± SD [hours]	11:12 ± 3:45
Preservation to surgery time, mean ± SD [days]	4.1 ± 1.1
Pre-processing ECC, mean ± SD [cells/mm^2]	2880.1 ± 166.7
Post-processing ECC, mean ± SD [cells/mm^2]	2808.0 ± 158.5
Demographic/clinical characteristics
Age, mean ± SD [years]	72.8 ± 10.0
Sex
Female, No. (%)	18 (75)
Male, No. (%)	6 (25)
Race
Caucasian, No. (%)	24 (100)
Operated eye
OD, No. (%)	10 (41.7)
OS, No. (%)	14 (58.3)
Lens status
Phakic, No. (%)	16 (66.7)
Pseudophakic, No. (%)	8 (33.3)
Indication for surgery
Fuchs’ endothelial dystrophy, No. (%)	21 (87.5)
Bullous keratopathy, No. (%)	2 (8.3)
Peter’s anomaly, No. (%)	1 (4.2)
Surgical procedure
DMEK, No. (%)	8 (33.3)
Triple-DMEK, No. (%)	16 (66.7)

Abbreviations: DMEK, Descemet membrane endothelial keratoplasty; SD, standard deviation; OD, oculus dexter; OS, oculus sinister; ECC, endothelial cell count.

Table 2 Clinical Outcomes Of DMEK Patients At All Time Intervals

Variable	Pre-Operative	1-Week Post-Operative	1-Month Post-Operative	3-Months Post-Operative	Last Examination
BCVA, median (range) [logMAR]	0.398 (0.097–1.398)	0.748 (0–2.3)	0.176 (0–0.875)	0.176 (0–1)	0.097 (0–0.796)
Spherical equivalent, median (range) [Diopters]	−1.25 (−9.5–1.875)	−1 (−9.5–1.875)	−0.875 (−3.125–1.625)	−0.188 (−3 – 2)	−0.438 (−4 – 2)
IOP, median (range) [mmHg]	14 (6–18)	14.5 (7–26)	12.5 (7–29)	13 (7–34)	13.5 (9–22)
Pachymetry, median (range) [μm]	651 (523–834)	665 (523–884)	610 (467–884)	558 (419–878)	533.5 (390–688)

Note: The mean follow-up duration was 13.3 ± 6.6 months for all patients and the range of last follow-up examination was 3–26 months.

Abbreviations: BCVA, best-corrected visual acuity; DMEK, Descemet membrane endothelial keratoplasty; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution.

Table 3 Subgroup Analyses Of All DMEK Patients

	DMEK alone (N=8)	Triple-DMEK (N=16)	P-Value	Re-bubbling (N=9)	No Re-bubbling (N=15)	P-Value
BCVA, median (range) [logMAR]
Pre-operative	0.544 (0.176–1.398)	0.398 (0.097–0.875)	0.09	0.301 (0.097–0.699)	0.477 (0.176–1.398)	0.01*
Post-operative, 1 week	0.651 (0.398–1.477)	0.796 (0–2.3)	0.56	1.301 (0–2.3)	0.699 (0–1.477)	0.27
Post-operative, 1 month	0.176 (0–0.875)	0.176 (0–0.875)	0.98	0.301 (0–0.875)	0.176 (0–0.875)	0.45
Post-operative, 3 months	0.301 (0.097–1)	0.137 (0–0.796)	0.06	0.176 (0–0.796)	0.176 (0–1)	0.38
Post-operative, last examination	0.176 (0–0.796)	0.097 (0–0.544)	0.08	0.097 (0–0.544)	0.097 (0–0.796)	0.85
Spherical equivalent, median (range) [Diopters]
Pre-operative	−1 (−1.375–1.375)	−1.563 (−9.5–1.875)	0.07	−1 (−2.5–1.5)	−1.375 (−9.5–1.875)	1.00
Post-operative, 1 week	−1 (−1.375–1.375)	−1.313 (−9.5–1.875)	0.23	−0.875 (−2.375–1.5)	−1.125 (−9.5–1.875)	0.63
Post-operative, 1 month	−0.688 (−2.25–0.625)	−0.938 (−3.125–1.625)	0.62	−1 (−3.125–0.125)	−0.75 (−2.25–1.625)	0.30
Post-operative, 3 months	−0.688 (−3–1.125)	0 (−2.125–2)	0.37	0 (−1.625–0.75)	−0.375 (−3–2)	0.68
Post-operative, last examination	−0.438 (−1.375–1.625)	−0.25 (−4–2)	0.78	−0.5 (−1.625–0.75)	−0.375 (−4–2)	1.00
IOP, median (range) [mmHg]
Pre-operative	14 (6–16)	14.5 (11–18)	0.16	15 (12–18)	14 (6–18)	0.21
Post-operative, 1 week	14 (7–21)	15 (7–26)	0.56	13 (7–18)	16 (7–26)	0.44
Post-operative, 1 month	12 (7–14)	13 (10–29)	0.22	12 (10–29)	13 (7–22)	0.93
Post-operative, 3 months	12 (7–20)	14.5 (10–34)	0.03*	13 (12–17)	13 (7–34)	0.81
Post-operative, last examination	12.5 (10–21)	14 (9–22)	0.83	13 (10–17)	14 (9–22)	0.70
Pachymetry, median (range) [μm]
Pre-operative	674 (534–834)	636.5 (523–749)	0.48	649 (523–749)	653 (534–834)	0.55
Post-operative, 1 week	718 (525–884)	620 (523–749)	0.13	649 (523–749)	681 (525–834)	0.84
Post-operative. 1 month	711 (467–884)	604.5 (479–878)	0.22	616 (523–884)	608 (467–834)	0.53
Post-operative, 3 months	569 (462–834)	557 (419–878)	0.90	560 (419–878)	557 (462–834)	0.79
Post-operative, last examination	512.5 (390–673)	533.5 (464–688)	0.43	538 (464–688)	494 (390–673)	0.27

Notes: Median (range) values shown. Wilcoxon rank-sum testing for comparisons between groups. *, P <0.05. The mean follow-up duration was 13.3 ± 6.6 months for all patients and the range of last follow-up examination was 3–26 months.

Abbreviations: BCVA, best-corrected visual acuity; DMEK, Descemet membrane endothelial keratoplasty; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution.