Endothelial Cell Density after Descemet Membrane Endothelial Keratoplasty: 1- to 2-Year Follow-up

PurposeTo evaluate donor endothelial cell density (ECD) after Descemet membrane endothelial keratoplasty (DMEK).DesignNonrandomized, prospective clinical study.MethodsFrom a larger group of patients who underwent DMEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy, complete ECD measurements were available of 26 patients with 6 and 12 months of follow-up, of whom 7 also had 24 months of follow-up.ResultsFor the group with 24 months of follow-up, ECD averaged 2700 (± 260) cells/mm2 before surgery, 2200 (± 460) cells/mm2 at 6 months after surgery, 2050 (± 330) cells/mm2 at 12 months after surgery, and 1780 (± 390) cells/mm2 at 24 months after surgery. For the group with 12 months of follow-up, ECD averaged 2620 (± 210) cells/mm2 before surgery, 1850 (± 540) cells/mm2 at 6 months after surgery, and 1680 (± 550) cells/mm2 at 12 months after surgery. In both groups, the ECD decreased significantly between the preoperative and 6-month measurement (P < .05).ConclusionsSimilar to earlier endothelial keratoplasty techniques, DMEK may be associated with a decrease in donor ECD of approximately 25% in the early postoperative phase.