{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:15:43Z","timestamp":1791558943850,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess the long\u2010term outcome of Descemet membrane endothelial keratoplasty (DMEK) following failed penetrating keratoplasty (PK).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of 1840 consecutive DMEK surgeries from the prospective Cologne DMEK database performed between 07\/2011 and 08\/2017 at the Department of Ophthalmology, University of Cologne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two eyes received a DMEK surgery after failed PK. Main indications for initial PK were Fuchs endothelial corneal dystrophy (23.1%), keratoconus and herpetic keratitis (each 15.4%). Best\u2010corrected visual acuity (BCVA) at 3, 6 and 12\u00a0months was 0.72\u00a0\u00b1\u00a00.39 (<jats:italic>n<\/jats:italic>\u00a0=\u00a033), 0.56\u00a0\u00b1\u00a00.36 (<jats:italic>n<\/jats:italic>\u00a0=\u00a032) and 0.38\u00a0\u00b1\u00a00.28 (<jats:italic>n<\/jats:italic>\u00a0=\u00a023), respectively. Two\u2010 and 3\u2010year BCVA was 0.37\u00a0\u00b1\u00a00.21 (<jats:italic>n<\/jats:italic>\u00a0=\u00a021) and 0.32\u00a0\u00b1\u00a00.18 (<jats:italic>n<\/jats:italic>\u00a0=\u00a010). Mean improvement in visual outcome in logMAR lines was +4.3\u00a0\u00b1\u00a03.4 at 6\u00a0months, +5.0\u00a0\u00b1\u00a03.6 at 12\u00a0months, +6.0\u00a0\u00b1\u00a02.3 at 24\u00a0months and +5.4\u00a0\u00b1\u00a02.7 at 36\u00a0months, respectively. 59.6% received at least one rebubbling and 40.4% did not necessitate a rebubbling. Endothelial cell density (ECD)\u2010decrease at 6\u00a0months was 36% (<jats:italic>n<\/jats:italic>\u00a0=\u00a017), 37% at 12\u00a0months (<jats:italic>n<\/jats:italic>\u00a0=\u00a017), 40% at 2\u00a0years (<jats:italic>n<\/jats:italic>\u00a0=\u00a08) and 32% at 3\u00a0years (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). 34.6% of transplants needed a regraft.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) is a feasible treatment option after failed PK having a relatively good long\u2010term outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14417","type":"journal-article","created":{"date-parts":[[2020,3,21]],"date-time":"2020-03-21T03:28:27Z","timestamp":1584761307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Long\u2010term outcome of descemet membrane endothelial keratoplasty (DMEK) following failed penetrating keratoplasty 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