{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:19:16Z","timestamp":1784956756069,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) accounts for &gt;50% of all corneal transplants in Germany. So far, no data from such a large multicenter study have been published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 3200 DMEKs at seven departments performed for Fuchs endothelial corneal dystrophy (FECD) or bullous keratopathy (BK). We evaluated best corrected visual acuity (BCVA, logMAR), endothelial cell density (ECD, cells\/mm<jats:sup>2<\/jats:sup>), minimal corneal thickness (CT, \u03bcm), rebubbling\u2010, primary transplant failure\u2010 and immune reaction\u2010rate. Changes over time were evaluated by linear mixed models for repeated measures and correlation with case number by center by weighted linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For patients without vision\u2010limiting comorbidities (74% of all analysed eyes, <jats:italic>n<\/jats:italic>\u00a0=\u00a02270), mean BCVA improved from 0.6\u2009\u00b1\u20090.4 logMAR to 0.2\u2009\u00b1\u20090.2 logMAR 6\u2009months (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>n<\/jats:italic>\u00a0=\u00a01441) and 0.1\u2009\u00b1\u20090.2 logMAR 12\u2009months (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001, <jats:italic>n<\/jats:italic>\u00a0=\u00a01402) postoperatively. BK\u2010 had a worse BCVA compared to FECD\u2010patients (0.3\u2009\u00b1\u20090.5 vs. 0.1\u2009\u00b1\u20090.2 logMAR [<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001] at 1\u2009year). ECD declined from 2465\u2009\u00b1\u2009259 cells\/mm<jats:sup>2<\/jats:sup> (<jats:italic>n<\/jats:italic>\u00a0=\u00a02876 preoperatively) to 1587\u2009\u00b1\u2009433 cells\/mm<jats:sup>2<\/jats:sup> after 12\u2009months (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>n<\/jats:italic>\u00a0=\u00a01237). Mean rebubbling rate was 0.4\u2009\u00b1\u20090.7\/eye. 784 eyes (25%) received at least one rebubbling. More rebubblings correlated with a lower ECD, a worse BCVA, a higher CT, and higher transplant failure and rejection rates (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013 for BCVA at 12\u2009months). A single rebubbling did not influence the BCVA (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.785). Graft failure rate was 3% (<jats:italic>n<\/jats:italic>\u00a0=\u00a067), rejection rate 1.5% (<jats:italic>n<\/jats:italic>\u00a0=\u00a048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Descemet membrane endothelial keratoplasty increases visual acuity with low transplant failure\u2010 and rejection\u2010rates. FECD has a better outcome than BK. Since a quarter of all patients need a rebubbling, this should be included in the informed consent. Remarkably, one rebubbling has no influence on the outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.15257","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T12:46:23Z","timestamp":1664541983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["<scp>DMEK<\/scp> outcome after one year \u2013 Results from a large multicenter study in Germany"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2560-7960","authenticated-orcid":false,"given":"Kristina","family":"Spaniol","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University Hospital D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hellmich","sequence":"additional","affiliation":[{"name":"Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Borgardts","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Girbardt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4549-3585","authenticated-orcid":false,"given":"Philip","family":"Maier","sequence":"additional","affiliation":[{"name":"Eye Center, Medical Center \u2013 University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Eye Center, Medical Center \u2013 University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Necip","family":"Torun","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Charit\u00e9 Universit\u00e4tsmedizin \u2013 Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humbolt\u2010Universit\u00e4t zu Berlin und Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-0254","authenticated-orcid":false,"given":"Anna\u2010Karina","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Charit\u00e9 Universit\u00e4tsmedizin \u2013 Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humbolt\u2010Universit\u00e4t zu Berlin und Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Thaler","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl U.","family":"Bartz\u2010Schmidt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wiedemann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Saarland University Medical Center  Homburg\/Saar 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