Determinants of One-Year Success in Descemet Membrane Endothelial Keratoplasty: Insights from the Diabetes Endothelial Keratoplasty Study

Introduction

Descemet membrane endothelial keratoplasty (DMEK) has emerged as a transformative surgical technique for treating corneal endothelial dysfunction, offering rapid visual recovery and excellent graft survival compared to traditional penetrating keratoplasty. Understanding factors that influence long-term graft success is critical to optimizing patient outcomes and refining surgical protocols. The Diabetes Endothelial Keratoplasty Study (DEKS), a multicenter randomized clinical trial, systematically evaluated the impact of various donor, lenticule preparation, recipient, and operative variables on one-year postoperative success rates. This article critically examines DEKS findings to elucidate determinants of DMEK success and their clinical implications.

Background and Clinical Context