Descemet membrane endothelial keratoplasty (DMEK) anatomic and functional results

Purpose: The aim of our study is to provide a better understanding of Descemet membrane endothelial keratoplasty (DMEK) technique by examining this treatment with our single center experience. Materials and Methods: Our study was performed retrospectively in 52 patients who underwent DMEK between 2018 and 2023 at Gaziantep University Hospital. Results: In our study, 29 of the patients were female and 23 were male. The mean age was 65.9 years. The lens status was phakic in 5, pseudophakic in 44, aphakic in 3 case. The indications were bullous keratopathy in 43 patients, Fuchs endothelial corneal dystrophy in 2, toxic anterior segment syndrome in 4, decompensated corneal edema after penetrating keratoplasty in 1, corneal edema after trauma in 1, and Chandler Syndrome in 1. There was a significant difference in best corrected visual acuity (BCVA) and central corneal thickness (CCT) values between preoperative and postoperative 6 months (p=0.001). Postop BCVA was above 0.3 LogMAR in 51% of patients with clear corneas. Of these patients, 25% had additional retinal pathology, 12.5% had glaucoma and 4.1% had uveitis. Rebubbling was performed in 13.4% of the patients and BCVA improved less in these patients. In addition, graft failure was found to be more frequent in patients who required rebubbling and the Re-DMEK was more frequent in patients without lens capsule support. Conclusion: Our study showed that DMEK treatment can be used successfully in endothelial pathologies of the cornea. Patients who required a rebubbling procedure had less vision improvement and graft failure was more frequent. Additionally, it should also be kept in mind that DMEK patients may be accompanied by additional ocular pathologies, which may also affect vision.