Study examines impact of donor tissue type on DMEK outcomes

Although pseudophakic donor grafts pose greater challenges during preparation and have longer recovery times compared to phakic and scarred stromal grafts, they can still provide comparable outcomes in Descemet membrane endothelial keratoplasty (DMEK) when complications do not occur, according to a study that advocates for the inclusion of pseudophakic grafts in corneal donation for DMEK, rather than excluding them given the shortage of corneal donors.

Researchers conducted a retrospective analysis of 484 eyes that underwent DMEK, categorizing them based on the donor tissue type.

The risk of complications during preparation was notably higher in the pseudophakic group compared to the other types. Although no significant differences in visual acuity were observed across the groups, recovery of central corneal thickness took longer for pseudophakic grafts, although it normalized after 3 months. In addition, the overall endothelial cell count was lower in the pseudophakic group.

The study found no significant difference in rebubbling rates among the donor groups. The researchers notes that the risk of needing repeat keratoplasty was lower for phakic grafts compared to pseudophakic ones.

The authors concluded that while pseudophakic donor grafts present unique challenges during preparation and longer recovery times, they can yield comparable outcomes when no complications arise.

Reference
Trouvain AM, Szurman P, Wahl S, Siegel R, Boden KT, Seitz B, Fries FN, Rickmann A. Impact of Previous Cataract Surgery in Corneal Donors on the Outcome of Descemet Membrane Endothelial Keratoplasty. Cornea. 2024;43(7):844-852. doi: 10.1097/ICO.0000000000003423. Epub 2023 Nov 7. PMID: 39377776.