DMEK Steroid Studies Update!

We reached an exciting milestone in 2015 by surpassing 2,000 DMEK cases and 4,000 total endothelial keratoplasty (DSEK and DMEK) procedures! All cases were performed at Price Vision Group, our clinical research partner. 
About two-thirds of those cases were performed in patients who had both eyes     treated here and one-third comprised patients who had a single eye treated. We’ve treated children to adults over 90 years old; two-thirds of which have been female. As we’ve improved the technique, people are no longer putting off having their eyes treated. The average age of our EK patients dropped from about 70 to about 65 years old.
Tracking thousands of cases has helped us make important discoveries about how to optimize the surgical technique and the post-operative care. The DMEK studies we’ve completed in the last couple of years have shown that within one to two months after surgery we can safely reduce the strength of the steroid eye drops used to prevent transplant rejection. This is helpful since we know from our data that 1 in 3 people develop pressure problems within one year of using the drops. By reducing the strength so soon after surgery, we greatly reduce the risk of developing steroid-induced glaucoma. 
Many of you participated in our recent study to assess the risk of rejection if the steroid eye drops are stopped at one year after DMEK. In the study, we tested two groups of people—the first stopped taking steroids entirely one year after DMEK while the second took a lower-dose steroid than was typically prescribed. Each group was followed for a year. We found that about 6 out of 100 people who stopped using the eye drops developed a rejection episode within 12 months. As a result, we recommend that patients keep using a low strength steroid eye drop once a day.
Long-term tracking of transplant outcomes has helped us document that graft survival rates are excellent with both DSEK and DMEK. We look forward to continuing to track the progress into the future as well as provide education to patients and doctors so DMEK is more easily available across the country. We now have over 200 DMEK  cases with follow up of 5 years or longer and over 100 DSEK cases with follow up of 10 years or longer. We are so appreciative when our early DSEK and DMEK patients respond to our requests to either come back so we can see how their transplants are doing or have an eye doctor closer to home send exam records to us. After all, one of the most common questions asked by patients facing surgery is “how long will this last?” We think DMEK grafts should last a lifetime but are looking forward to tracking this long-term. Through participating in our Cornea Transplant Database, each of our transplant recipients is helping us improve cornea transplant outcomes around the world. Thank you to those who support our work to make these findings possible!
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