March 3, 2026Open Access

Corneal Stromal Thinning and Posterior Irregularity After DMEK: Clinical Observations and Biophysical Hypotheses

Key Points

Postoperative stromal thinning correlates with reduced corneal thickness and hyperopic shift after DMEK.
Greater reductions in corneal thickness are linked to preoperative stromal ripples and endothelial recovery.
Observations indicate that stromal remodeling is influenced by the biomechanical status of the cornea, highlighting its role.
The study suggests potential implications of keratocyte loss and osmotic imbalance in corneal health post-surgery.

Abstract

Greater reductions in corneal thickness are associated with postoperative stromal thinning and hyperopic shift after DMEK. Preoperative stromal ripples are associated with greater reductions in corneal thickness after DMEK. Stromal remodeling appears influenced by endothelial recovery and preoperative biomechanical status, supporting emerging hypotheses on keratocyte loss and osmotic imbalance.

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Discussion

Journals

Cornea

Institutions

Université de Montréal

University of Liverpool

Cardiff University

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