Descemet membrane endothelial keratoplasty in vitrectomized eyes: clinical results.

Purpose: The aim of this study was to evaluate clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) in vitrectomized eyes.

Methods: Medical records were reviewed for demographics, baseline and follow-up best spectacle-corrected visual acuities (BCVAs), endothelial cell densities, and indication for DMEK. Operative notes were analyzed to identify any specific intraoperative event.

Results: A total of 281 DMEK cases were reviewed. Twenty cases were considered eligible for the study. Seven eyes had a history of anterior vitrectomy, and 13 eyes had a history of complete removal of the vitreous body. Ages ranged from 37 to 78 years (mean, 62.9 years) and mean follow-up after DMEK was 11.2 months (range, 3-29 months). The preoperative mean BCVA was 1.4 ± 0.5 logarithm of minimum angle of resolution (logMAR) and increased to 1.0 ± 0.5 logMAR after 4 weeks (P = 0.0290). After 6-month and 12-month follow-up, BCVA was 0.8 ± 0.6 logMAR (P = 0.0055) and 0.6 ± 0.3 logMAR (P = 0.0001), respectively. All cases had ocular comorbidities affecting the BCVA. In 13 cases, significant intraoperative complications were experienced. In the immediate postoperative period, iatrogenic primary graft failure was reported in 2 eyes (2/20). In 4 eyes, late graft failure was observed. Two eyes had exacerbation of preexisting glaucoma. Mean preoperative endothelial cell density was 2301 ± 159 cells per square millimeter; postoperative follow-up visits at 6 and 12 months showed a decrease to 1398 ± 161 cells per square millimeter and 1241 ± 155 cells per square millimeter, respectively.

Conclusions: DMEK seems to be successful in restoring visual acuity even in vitrectomized eyes. Nevertheless, the overall complication rate was higher than that in standard DMEK.