DMEK outcomes using nondiabetic grafts for recipients with diabetes mellitus

Ben J Janson; Daniel C Terveen; Matthew J Benage; M Bridget Zimmerman; David C Mixon; Benjamin T Aldrich; Jessica M Skeie; Gregory A Schmidt; Cynthia R Reed; Kenneth M Goins; Mark A Greiner

doi:10.1016/j.ajoc.2019.100512

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DMEK outcomes using nondiabetic grafts for recipients with diabetes mellitus

Journal article

Open access

Peer reviewed

DMEK outcomes using nondiabetic grafts for recipients with diabetes mellitus

Ben J Janson, Daniel C Terveen, Matthew J Benage, M Bridget Zimmerman, David C Mixon, Benjamin T Aldrich, Jessica M Skeie, Gregory A Schmidt, Cynthia R Reed, Kenneth M Goins, …

American journal of ophthalmology case reports, Vol.15, pp.100512-100512

09/2019

DOI: 10.1016/j.ajoc.2019.100512

PMCID: PMC6630035

PMID: 31341996

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Abstract

To compare Descemet membrane endothelial keratoplasty (DMEK) outcomes using nondiabetic grafts in diabetic and nondiabetic recipients. All eyes that underwent DMEK between February 2013 and October 2016 (follow-up ≥3 months, without prior keratoplasty) were included. Recipients were divided into diabetic (insulin dependent [IDDM] or noninsulin dependent [NIDDM]) and nondiabetic groups. Main outcome measures included postoperative visual acuity, rebubble procedure rates, and graft failure rates. Of 334 eyes (243 subjects) included for analysis, 63 eyes (18.8%) were from diabetic recipients. At each timepoint, best-corrected visual acuity trended lower for IDDM recipients compared to NIDDM and nondiabetic recipients. There were no statistically significant differences in rebubble rates of diabetic compared to nondiabetic recipients (20.6% vs. 12.9%, p = 0.17), or IDDM compared to nondiabetic recipients (27.3% vs. 12.9%, p = 0.08; hazard ratio 2.26). Overall, 13 grafts (3.9%) failed (mean follow-up, 565 days; range, 90-1293 days). Graft failures did not differ between diabetic and nondiabetic recipients (4.0% vs. 4.9%, p = 0.15) regardless of subgroup (p = 0.36). DMEK provides excellent outcomes for patients with and without diabetes. DMEK outcomes were excellent with improvements in visual acuity and low rates of graft failure. Our findings were unable to determine differences between rebubble procedure rates but do emphasize the need for further research using stratified groups based on diabetes severity.

Endothelial keratoplasty

Corneal transplantation

Diabetes mellitus

Corneal endothelium

Descemet membrane

DMEK

Details

Title: Subtitle: DMEK outcomes using nondiabetic grafts for recipients with diabetes mellitus
Creators: Ben J Janson - University of Iowa
Daniel C Terveen - University of Iowa
Matthew J Benage - University of Iowa
M Bridget Zimmerman - University of Iowa
David C Mixon - Lions Eye Bank (Coralville)
Benjamin T Aldrich - University of Iowa
Jessica M Skeie - University of Iowa
Gregory A Schmidt - University of Iowa
Cynthia R Reed - University of Iowa
Kenneth M Goins - University of Iowa
Mark A Greiner - University of Iowa
Resource Type: Journal article
Publication Details: American journal of ophthalmology case reports, Vol.15, pp.100512-100512
DOI: 10.1016/j.ajoc.2019.100512
PMID: 31341996
PMCID: PMC6630035
NLM abbreviation: Am J Ophthalmol Case Rep
ISSN: 2451-9936
eISSN: 2451-9936
Language: English
Date published: 09/2019
Academic Unit: Biostatistics; Ophthalmology and Visual Sciences
Record Identifier: 9984181078302771

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