Medication practices after DMEK surgery vary widely across Europe due to lack of standard guidelines
Medication practices following Descemet Membrane Endothelial Keratoplasty (DMEK) surgery vary widely across Europe due to a lack of standardized guidelines, with most surgeons relying on local protocols or personal experience rather than national recommendations, according to a study.
The study, conducted across 16 national societies affiliated with the European Cornea and Cell Transplantation Registry and the European Vision Institute Clinical Research Network, included responses from 136 surgeons.
Most surgeons relied on departmental protocols or personal experience to guide medication choices, with only a minority following national guidelines. Antibiotics were commonly used during and after surgery to prevent infection, and relied on steroids to prevent graft rejection. Dexamethasone was the most frequently used steroid, typically tapered over several months.
In cases considered high-risk for rejection, many surgeons opted to add another topical or systemic immunosuppressant. Management of postoperative complications, like pupillary block or steroid-induced ocular hypertension, also varied widely, underscoring the absence of standardized practices.
Reference
Ye Y, de Rooij F, Alejandre N, et al. Prescription Patterns in Descemet Membrane Endothelial Keratoplasty (DMEK): A European Survey. J Cataract Refract Surg. 2025;doi: 10.1097/j.jcrs.0000000000001726. Epub ahead of print. PMID: 40558573.
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