This thesis focuses on the clinical outcomes after Descemet membrane endothelial keratoplasty (DMEK). Chapter 2 describes the suitability of septic donor corneas for transplantation and the... Show moreThis thesis focuses on the clinical outcomes after Descemet membrane endothelial keratoplasty (DMEK). Chapter 2 describes the suitability of septic donor corneas for transplantation and the clinical outcomes after DMEK using septic versus non-septic donor corneas. Chapter 3 aims to analyze the incidence of cataract extraction in eyes that previously underwent DMEK surgery and the effect of the phacoemulsification procedure on the endothelial cell density (ECD) after DMEK. Chapter 4 of the thesis concentrates on the 6-month ECD after DMEK, as it is one of the benchmark parameters for graft performance. In this chapter, the relation between the ECD 6 months after DMEK and its predictive value for 5-year graft survival in FECD eyes are discussed. Chapter 5 evaluates the 10-year graft survival and clinical outcome results of the first 100 eyes that received DMEK. Chapter 6 presents a larger case series of DMEK eyes where the 10-year clinical outcomes and graft survival after DMEK are analyzed based on the surgical indication of the eye and the preoperative severityof FECD. Show less
The thesis focuses on the in vivo and in vitro behavior of corneal endothelial cells before and after endothelial keratoplasty. The first part of the project concentrates on the ECD decrease after... Show moreThe thesis focuses on the in vivo and in vitro behavior of corneal endothelial cells before and after endothelial keratoplasty. The first part of the project concentrates on the ECD decrease after DMEK and DMEK graft viability prior to transplantation. The second part focusses on regenerative strategies for the treatment of FECD by developing and applying in vitro cell migration assays. In vitro cell migration from DMEK grafts of various sizes and shapes are investigated in a 3D cell culture system aiming to identify critical parameters for the successful clinical application of corneal endothelial therapies. Show less