DMEK in Super-Seniors: Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty Performed in Patients Greater Than 90 Years Old | ASCRS
Presentation
DMEK in Super-Seniors: Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty Performed in Patients Greater Than 90 Years Old
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other
Authors: Philip W. Dockery, MPH, Jack Parker PhD, MD, Christina Parker MA, John Parker MD, Gerrit RJ. Melles MD, PhD
This content is only available for ASCRS Members

This content from the 2020 ASCRS Virtual Annual Meeting is only available to ASCRS members. To log in, click the teal "Login" button in the upper right-hand corner of this page.

Purpose
To evaluate the clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed in the “oldest old” patients, i.e. ≥ 90 years.

Methods
Between the years of 2009 and 2019, 20 consecutive eyes of 17 patients aged ≥ 90 underwent DMEK for endothelial dysfunction. Best corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), graft survival, and intra- and postoperative complications were assessed.

Results
Except in one case in which the DMEK surgery could not be completed, all operated eyes experienced an improvement in BCVA, although only 50% achieved ≥ 20/40 (0.5) by 1 year postoperatively. One year after surgery, median CCT had declined from 641(+/-161) μm to 480 (+/-34) μm (p<0.001), and median endothelial cell density was reduced by 53%, from 2574 (+/-286) to 1226 (+/-404) cells/mm2. Six of 19 eyes receiving DMEK grafts (32%) developed partial graft detachments requiring re-bubbling. One eye experienced a secondary graft failure at 6 months and underwent repeat endothelial keratoplasty.

Conclusion
DMEK is technically feasible in the oldest old patients and may yield significant visual improvements. Because clinical follow-up may be difficult for these patients, DMEK may be preferable to Descemet stripping endothelial keratoplasty and penetrating keratoplasty because the risk of suture related issues and allograft reaction/rejection is lower.
View More Presentations from this Session

This presentation is from the session "SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

We use cookies to measure site performance and improve your experience. By continuing to use this site, you agree to our Privacy Policy and Legal Notice.