DMEK Surgery at a Tertiary Hospital in Sweden. Results and Complication Risks

Figures & data

Table 1 Recipient Demographics and Surgical Procedures in 162 Eyes from 120 Patients

		N
Mean age (±SD), years; range	70 (±8); 24–86
Sex (female eyes/ male eyes)	62%/38%	101/61
Indication for DMEK
FECD	94.5%	153
Failed DSEK	4.3%	7
Bullous keratopathy	0.6%	1
Congenital hereditary corneal dystrophy	0.6%	1
Preoperative lens status (pseudophakic/phakic)	98.8%/1.2%	160/2
Ocular comorbidity preoperatively	12.3%	20
Surgical procedure
DMEK	99.4%	161
DMEK + phacoemulsification + IOL	0.6%	1

Abbreviations: N=number; DMEK=Descemet’s membrane endothelial keratoplasty; DSEK=Descemet’s stripping endothelial keratoplasty; ; FECD=Fuchs endothelial corneal dystrophy; IOL= intraocular lens; SD= standard deviation.

Figure 1 Best spectacle corrected visual acuity (BSCVA) before and 1 month after DMEK (decimal), eyes without comorbidities.

Figure 2 Best spectacle corrected visual acuity (BSCVA) before and 1 month after DMEK (decimal), eyes with comorbidities.

Table 2 Visual Acuity of 129 Eyes Without Comorbidities in logMAR; and Decimal Notation

	Preoperatively	At 1 Month	At the Examination Time Point
25th percentile	0.70; 0.2	0.22; 0.6	0.10; 0.8
Median (range)	0.52 (0.15–2.0); 0.3	0.15 (0–0.8); 0.7	0; (0–0.9); 1.0
75th percentile	0.40; 0.4	0.10; 0.8	0; 1.0

Notes: Italicized values show the range of the visual acuity in logMAR.

Abbreviation: logMAR= the logarithm of the minimum angle of resolution.

Table 3 Visual Acuity of 20 Eyes with Comorbidities in logMAR; and Decimal Notation

	Preoperatively	At 1 Month	At the Examination Time Point
25th percentile	0.89; 0.13	0.65; 0.22	0.43; 0.37
Median (range)	0.52 (0.4–1.52); 0.3	0.35 (0.15–1.52); 0.45	0.30 (0.1–2.0); 0.50
75th percentile	0.40; 0.4	0.28; 0.52	0.20; 0.63

Notes: Italicized values show the range of the visual acuity in logMAR.

Abbreviation: logMAR= the logarithm of the minimum angle of resolution.

Figure 3 Best spectacle corrected visual acuity (BSCVA) up to 6 years after DMEK (decimal): eyes without comorbidities.

Figure 4 Best spectacle corrected visual acuity (BSCVA) up to 6 years after DMEK (decimal): eyes with comorbidities.

Table 4 Endothelial Cell Density (ECD) and Cell Loss – Cross-Sectional Analysis

Years Postoperatively	Number of Eyes	ECD cells/mm^2 Median (Interquartile Range)	ECD loss, % Median (Interquartile Range)
0 (baseline donor)	144	2625 (2500, 2831)	–
1–2	40	2052 (1350, 2402)	27 (15, 46)
2–3	46	1819 (1294, 2178)	31 (22, 45)
3–4	29	1585 (1136, 1949)	42 (29, 57)
4–5	13	822 (703, 1406)	65 (13, 72)
>5	16	982 (830, 1094)	62 (16, 67)

Abbreviation: ECD= endothelial cell density;

Figure 5 Endothelial cell density loss. The boxes are drawn between the 25th and 75th percentiles. The horizontal lines show the median, while the whiskers indicate the minimum and maximum values.

Abbreviation: ECD= endothelial cell density.

Table 5 Effects on Endothelial Cell Density (ECD)– Multiple Linear Regression

			95% Confidence Interval for B
Model	Coefficient B	Significance	Lower Border	Upper Border
(Constant)	−1745,67	0.001	−2793,05	−698,30
Baseline (donor) ECD	1,40	< 0.001	1,04	1,78
Time since surgery (years)	−142,92	< 0.001	−212,27	−73,59

Notes: Method: Forward (criterion: probability to enter: p <= 0.05).

Abbreviation: Coefficient B= coefficient beta.