Determinants of Endothelial Cell Density One Year After DMEK: Insights from the Diabetes Endothelial Keratoplasty Study

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The Diabetes Endothelial Keratoplasty Study (DEKS) identified preoperative donor endothelial cell density (ECD), donor endothelial cell damage assessed via trypan blue staining, the recipient’s diagnosis, and intraoperative complications as significant predictors of endothelial cell density at one year following Descemet membrane endothelial keratoplasty (DMEK).

Higher endothelial cell loss correlated with increased donor endothelial cell damage, non-Fuchs endothelial corneal dystrophy (FECD) recipient diagnoses, and operative complications. These findings emphasize the importance of meticulous donor tissue preparation and operative technique to optimize long-term graft endothelial survival.