Survivability of locally prepared versus imported Descemet membrane endothelial keratoplasty grafts in Edmonton.

OBJECTIVE

This study aimed to evaluate the long-term graft survivability of locally prestripped versus imported prestripped Descemet membrane endothelial keratoplasty (DMEK) grafts in Edmonton.

DESIGN

Prospective cohort study of patients who underwent DMEK surgery between January 1, 2020, and December 31, 2020.

PARTICIPANTS

All patients receiving a DMEK transplant during the study period in Edmonton.

METHODS

Two local technicians were trained to prestrip DMEK grafts in Edmonton. When available, local tissue was prestripped for DMEK surgery; otherwise, prestripped DMEK grafts were imported from an accredited American eye bank. Patient characteristics and DMEK graft characteristics and DMEK survivability were evaluated and compared between the 2 groups.

RESULTS

Thirty-two locally prestripped DMEK grafts and 35 imported prestripped DMEK grafts were used during the study period. Donor cornea characteristics and patient characteristics were similar between the 2 groups. Best-corrected visual acuity improved up to 6 months postoperatively and was 0.2 logMAR in the locally prestripped DMEK group and 0.2 logMAR in the imported DMEK group (p = 0.56). Rebubble rates were 25% in the locally prestripped DMEK group and 19% in the imported DMEK group (p = 0.43). There was 1 primary graft failure in each group (p = 0.93). Endothelial cell density decreased by 37% in the locally prestripped DMEK group and by 33% in the imported DMEK group 2 years after transplantation.

CONCLUSIONS

The long-term survivability of locally prepared DMEK grafts is comparable with that of DMEK grafts imported from American eye banks.