DMEK Outcomes Discussed at RANZCO Cornea Society Meeting

As one of only a few surgeons performing DMEK (Descemet’s membrane endothelial keratoplasty) surgery in the Melbourne area, I was invited to give a talk about DMEK outcomes and tips on learning the technique at the RANZCO Cornea Society Meeting.  The annual meeting, which was held in Melbourne this year, brings together cornea specialists, optometrists, eye bankers, and scientists to discuss all matters pertaining to the cornea, eye banking, refractive surgery, and contact lenses.  Guest speakers were invited from across Australia and New Zealand, as well a North America, Europe, and Asia. 

Talks relating to new techniques and technology are always popular amongst attendees.  This is particularly true when new techniques can make a dramatic improvement for patients.  The scientific literature supports the ideas that DMEK gives faster visual recovery, better visual outcomes, and less risk of rejection compared with alternative endothelial transplant techniques, such as DSEK (Descemet’s stripping endothelial keratoplasty), UT-DSEK (ultra thin DSEK), or PK (penetrating keratoplasty). 

I reviewed all the cases of DMEK that have been completed in Melbourne, and highlighted that the overall success rate has been 78%, which is consistent with other early case series quoted in the literature.  I also discussed the increased success rate with numbers of cases completed by each surgeon.  In fact, when I looked at all surgeon’s first cases, there was only a 25% success rate.  In second cases, there was a 67% success rate.  Impressively, looking at third cases and beyond, the success rate has been 100%.  It is important to understand that this is a small sample of data and that prior results do not guarantee success with future results.  However, the important aspect is that we have been able to significantly shorten and improve our learning curves by collaborating and sharing ideas with other cornea specialists and eye bankers. 

I look forward to reviewing our collective data again in a year’s time to see if more cornea surgeons are offering this type of transplant in Melbourne.  Having shared ideas and chatted with my colleagues in the United States, I realise that the technique is becoming very popular there.  Most cornea surgeons are offering the procedure or are planning on offering it in the next year.  Perhaps in the near future, it will become the standard of care for endothelial disease. 

If you are suffering from endothelial disease, such as Fuchs’ corneal dystrophy, make an appointment for a complete eye examination, and I will be happy to discuss the various options to improve your vision.  Please see the cornea transplant section for more information.