Study of corneal endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty

Abstract

Background To study the endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty (DMEK) using specular microscopy to provide data about the endothelial cell density (ECD), endothelial cell loss (ECL) percentage, and changes in endothelial cell shape (hexagonality) and size [coefficient of variation (CV)] and to study the factors causing these changes in endothelial cell layer after DMEK. Patients and methods This study included 20 patients investigated by specular microscopy 3 months after DMEK. We discuss the postoperative ECD, factors that affect the ECD, factors that affect hexagonality and CV, visual outcome, and advantages of DMEK. The study was approved by the ethics committee of Ain Shams University. Results This study showed that the mean ECD postoperative was 1664.80 cells/mm2, with mean ECL of 34.67%. This cell loss increased in cases of difficult graft unfolding. Donor age and preservation time had no effect on postoperative ECD. A percentage decrease in hexagonal cells and a percentage increase in CV were noticed in cases that received grafts from donors with history of diabetes mellitus. Postoperative ECD and hexagonal cell percentage had no correlation with central corneal thickness in this study. Conclusion DMEK results in significant improvement of postoperatively visual acuity (VA). Advantages of DMEK like no corneal sutures, short recovery time, less cylindrical aberration, decreased incidence of graft rejection, and good visual outcome make it the best choice to treat eyes with corneal endothelial dysfunction.