Purpose: 

The purpose of this study is to analyze the course of corneal densitometry (CD), endothelial cell density (ECD), best-corrected visual acuity (BCVA), and central corneal thickness (CCT) 5 years after uneventful Descemet membrane endothelial keratoplasty (DMEK).

Methods: 

Sixty uneventful cases (51 patients) with a minimum follow-up of 5 years were included. CD of various corneal layers (anterior, central, posterior, and total layer) and zones (0–2 mm, 2–6 mm, and 6–10 mm) were measured with Scheimpflug tomography. ECD, BCVA, and CCT were also evaluated.

Results: 

Total CD at 0 to 2 mm and 2 to 6 mm zones significantly decreased from 33 ± 10 and 27.8 ± 8 grayscale units (GSU) preoperatively to 21.8 ± 3.1 and 22.2 ± 4.2 GSU at 5 years, respectively (P < 0.001). On the contrary, total CD at the 6 to 10 mm zone significantly increased from 30 ± 8.3 GSU preoperatively to 34.6 ± 7.8 GSU at 5 years (P < 0.001). ECD significantly decreased from 2496 ± 267 cells/mm² preoperatively to 1063 ± 470 cells/mm² at 5 years (P < 0.001). Similarly, CCT significantly decreased from 686 ± 109 μm preoperatively to 557 ± 37 μm at 5 years (P < 0.001). Postoperative BCVA was significantly better after DMEK for every examination time point.

Conclusions: 

Despite a slight CD increase at all layers of all corneal zones from the second to the fifth postoperative year, the excellent visual outcome was maintained throughout 5-year follow-up. Thus, DMEK seems to effectively treat corneal endothelial disease in the long term.

中文翻译：

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平稳的后弹力膜内皮角膜移植术后角膜密度测定——5 年结果

目的： 

本研究的目的是分析平稳的后弹力膜内皮角膜移植术 (DMEK) 5 年后角膜密度测定 (CD)、内皮细胞密度 (ECD)、最佳矫正视力 (BCVA) 和中央角膜厚度 (CCT) 的过程）。

方法： 

包括至少随访 5 年的 60 例平安无事的病例（51 名患者）。用 Scheimpflug 断层扫描测量各种角膜层（前层、中央层、后层和总层）和区域（0-2 毫米、2-6 毫米和 6-10 毫米）的 CD。还评估了 ECD、BCVA 和 CCT。

结果： 

0 至 2 mm 和 2 至 6 mm 区域的总 CD 从术前的 33 ± 10 和 27.8 ± 8 灰度单位 (GSU) 分别显着降低至 5 年时的 21.8 ± 3.1 和 22.2 ± 4.2 GSU ( P < 0.001)。相反，6 至 10 mm 区域的总 CD 从术前的 30 ± 8.3 GSU 显着增加至 5 年的 34.6 ± 7.8 GSU ( P < 0.001)。ECD 从术前的 2496 ± 267 个细胞/mm ²显着下降到 5 年的 1063 ± 470 个细胞/mm ² ( P < 0.001)。同样，CCT 从术前的 686 ± 109 μm 显着降低至 5 年时的 557 ± 37 μm（P < 0.001）。DMEK 后每个检查时间点的术后 BCVA 明显好转。

结论： 

尽管从术后第 2 年到第 5 年，所有角膜区域的所有层的 CD 略有增加，但在 5 年的随访中保持了良好的视觉效果。因此，DMEK 似乎可以长期有效地治疗角膜内皮疾病。