Clinical outcomes in imported endothelium-in preloaded vs. surgeon-loaded DMEKs in Asian eyes

This is the authors' abstract. We don't add key points for this paper.

Purpose: To perform a direct, prospective, comparative analysis of the complications associated with imported preloaded grafts versus surgeon-loaded grafts in Descemet membrane endothelial keratoplasty (DMEK) in Asian eyes. Methods: A total of 20 consecutive preloaded DMEKs were matched by donor age with 40 surgeon-loaded DMEKs for the indications of Fuchs' endothelial cell dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). All cases of preloaded and surgeon-loaded DMEKs were by a single surgeon in the Singapore National Eye Centre and utilized endothelium-in pull-through cartridges (CORONET DMEK Endoglide; Network Medical Products, United Kingdom). Imported preloaded grafts were prepared 72 to 96 h before surgery. The main outcome measures were intra-operative complications such as graft tears, extrusion, and high vitreous pressure. Secondary outcome measures were endothelial cell loss and early post-operative complications such as ocular hypertension, graft detachment, and rebubbling, up to 6 months post-operatively. Visual outcomes and endothelial cell loss were not significantly different in both groups. Conclusion: In our Asian study cohort of pull-through DMEKs, endothelium-in preloaded DMEKs were significantly faster than surgeon-loaded DMEKs and had comparable clinical outcomes.