{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:51:43Z","timestamp":1793404303746,"version":"4.5.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the effect of surgical indications and complexity on long-term clinical outcomes in Descemet membrane endothelial keratoplasty (DMEK) and identify early signs of graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective case series of 105 patients who underwent DMEK from March 2012 to December 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Surgical results were analyzed at 1 year, 3 years, 5 years, and 10 years based on surgical indication: fuchs endothelial dystrophy (FECD) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 47) and bullous keratopathy (BK) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 58), and on the presence of anterior segment comorbidities: simple (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 63) versus complex (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 42) DMEK.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty-two patients (54 eyes) were followed up for 3 years, 35 patients (42 eyes) reached the 5-year follow-up, and 20 patients (26 eyes) achieved the 10-year follow-up. Simple DMEK procedures and FECD demonstrated significantly better best corrected visual acuity (BCVA) compared to complex DMEK and BK at 1 year, 3 years, 5 years, and 10 years, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). No statistically significant difference in endothelial cell density (ECD) decline was noted between simple and complex DMEK procedures, nor between FECD and BK (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). Central and peripheral pachymetry were significantly higher in BK and complex surgeries at 10 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While DMEK represents a promising therapeutic avenue for corneal decompensation alongside anterior segment comorbidities, extended follow-up indicates a rise in central and peripheral pachymetry in comparison with simple DMEK. This increase could serve as an early indicators of corneal decompensation, potentially leading to reduced survival rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2273_24","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T07:00:11Z","timestamp":1751266811000},"page":"1021-1026","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Ten years of Descemet membrane endothelial keratoplasty: Identifying risk factors and early failure signs"],"prefix":"10.4103","volume":"73","author":[{"given":"Nicole","family":"Mechleb","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France"},{"name":"CEROV: Center of Expertise and Research in Visual Optics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France"},{"name":"CEROV: Center of Expertise and Research in Visual Optics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Debellemani\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France"},{"name":"CEROV: Center of Expertise and Research in Visual Optics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Gatinel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France"},{"name":"CEROV: Center of Expertise and Research in Visual Optics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France"},{"name":"CEROV: Center of Expertise and Research in Visual Optics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/ICU.0000000000000080","article-title":"Trends in corneal transplantation: Indications and techniques","volume":"25","author":"Ple-Plakon","year":"2014","journal-title":"Curr Opin Ophthalmol"},{"key":"R2-20260421","article-title":"Long-term outcomes after lamellar endothelial keratoplasty compared with penetrating keratoplasty for corneal endothelial dysfunction: A systematic 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