Descemet membrane endothelial keratoplasty versus descemet's stripping automated endothelial keratoplasty following glaucoma filtering surgery: clinical outcomes and immunologic considerations.

Hirotsugu Kasamatsu, Shizuka Koh, Yukari Yagi-Yaguchi, Daisuke Tomida, Takefumi Yamaguchi

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Article in Japanese journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Hirotsugu KasamatsuDepartment of Ophthalmology, International University of Health and Welfare Ihikawa General Hospital, 5 Chome-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan.

Shizuka KohDepartment of Innovative Visual Science, The University of Osaka Graduate School of Medicine, Osaka, Japan.

Yukari Yagi-YaguchiDepartment of Ophthalmology, International University of Health and Welfare Ihikawa General Hospital, 5 Chome-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan.

Daisuke TomidaDepartment of Ophthalmology, International University of Health and Welfare Ihikawa General Hospital, 5 Chome-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan.

Takefumi YamaguchiDepartment of Ophthalmology, International University of Health and Welfare Ihikawa General Hospital, 5 Chome-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan. yamaguchi-takefumi-rd@ihwg.jp.ORCID http://orcid.org/0000-0002-2546-2813

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6 · The paper itself

Abstract

purposeTo investigate the clinical outcomes and immunologic implications following Descemet membrane endothelial keratoplasty (DMEK) and Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with prior glaucoma filtering surgery (GFS). STUDY

designRetrospective comparative case series.

methodsThis study included 29 eyes with prior GFS that underwent DMEK (n=7) or DSAEK (n=22). Outcomes include host central corneal thickness (CCT), short-term complications (graft detachment, rebubbling, and primary graft failure [PGF]), corrected distance visual acuity (CDVA), immunologic graft rejection, endothelial cell loss (ECL), and graft survival.

resultsDMEK showed significantly faster recovery of host CCT compared to DSAEK on postoperative day 1 (573.2 ± 93.3 μm vs. 773.0 ± 40.7 μm; p = 0.02) and day 3 (591.1 ± 93.2 μm vs. 721.5 ± 108.9 μm; p = 0.003). Graft detachment rates were similar between the groups; rebubbling and PGF occurred only after DSAEK (14% and 9%). CDVA at 1 month (0.5 ± 0.5 vs. 1.0 ± 0.5) and at 3 months (0.4 ± 0.4 vs. 0.8 ± 0.4) was significantly better in the DMEK group (both p = 0.04). The 2-year cumulative rejection rates (14% in both groups), 2-year ECL (70 ± 17% vs. 71 ± 15%), and 2-year graft survival rate (100% vs. 81 ± 10%) were comparable.

conclusionsDMEK appears to be a viable option after GFS, given its favorable clinical profile. However, the relatively high incidence of immunologic events in both groups suggests that alterations in the ocular immune environment following GFS may influence postoperative outcomes.

Indexed as

Descemet membrane endothelial keratoplastyDescemet’s stripping automated endothelial keratoplastyEndothelial keratoplastyGlaucoma filtering surgeryImmunologic graft rejection

Identifiers

PMID42536334

DOI10.1016/j.ajo.2019.06.012

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.