ROME — Descemet’s membrane endothelial keratoplasty is showing superior results over time compared to Descemet’s stripping endothelial keratoplasty in terms of optical quality and rejection rate with low-dose steroids in internationally published data, according to a specialist.
“In my nearly 3 years of experience, I have learned to increasingly appreciate the advantages of DMEK, which has now become my favorite approach,” José Güell, MD, said at the joint Refractive.online and SICCSO meeting.
Güell now uses DSEK only in aphakic eyes or eyes with anterior chamber IOLs.
“In the near future, as the technique evolves, also these limitations may be overcome,” he said.
Tissue preparation, insertion and handling in the eye are crucial aspects that still need improvement to preserve endothelial cell integrity and lower the detachment rate.
“We are doing better with the new inserters that reduce donor manipulation, but at least in my country, we are experiencing problems due to the learning curve of eye banks in preparing the tissue,” Güell said.
A study recently published by Price and colleagues showed that the rejection rate was considerably lower with DMEK compared to DSEK, with a proportion of 1:8 at 1 year and 1:12 at 2 years.
“In consideration of this low rejection rate, we are now starting to evaluate a low-dose steroid regimen following DMEK,” Güell said.
- Disclosure: Güell has no relevant financial disclosures.