الفهرس | Only 14 pages are availabe for public view |
Abstract Background: The cornea is a transparent avascular tissue that acts as a structural barrier and protects the eye. The corneal layers include epithelium, Bowman’s layer, stroma, dua layer, Descemet’s membrane, and endothelium. Pathologies of corneal endothelium lead to corneal edema and visual affection which is treated with Descemet membrane endothelial keratoplasty. Aim of the work: To study the endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty using specular microscopy to provid data about the endothelial cell density (ECD) , endothelial cell loss percentage (ECL) , changes in endothelial cell shape (hexagonality) and size (co-efficient of variation) and study the factors cause these changes on endothelial cell layer after DMEK . Patient and Methods: This study included 20 patients investigated by specular microscopy 3 months after DMEK . We discuss the ECD postoperative, factors affect the ECD, factors affect hexagonality and coefficient of variation, visual outcome and advantages of DMEK. Results: This study showed that the mean endothelial cell density postoperative was 1664.80 cells/mm2 with mean endothelial cell loss 34.67 %. These cells loss increased in cases of difficult graft unfolding. Donor age and preservation time had no effect on postoperative ECD. The decrease in hexagonal cells % and increase in coefficient of variation % noticed in cases that received grafts from donors with history of diabetes mellitus. Posroperative ECD, hexagonal cells percentage have no correlation with central corneal thickness in this study. Conclusion: DMEK results in significant improvement of VA postoperative. Advantages of DMEK like no corneal sutures, short recovery time, less cylindrical abberation, decreased incidence of graft rejection and good visual outcome make it the procedure of choice for eyes with corneal endothelial dysfunction |