Authors:Yelin Yang, Fargol Mostofian, Javiera Compan, Kashif Baig
Author Disclosure Block: Y. Yang: None. F. Mostofian: None. J. Compan: None. K. Baig: None.

Abstract Body:

Purpose: Hemi-Descemet Membrane Endothelial Keratoplasty (hemi-DMEK) has been described as a technique to increase the availability of donor cornea by splitting donor corneal transplant into two separate grafts. The purpose of this study is to evaluate the long-term outcome after Hemi-DMEK at a single tertiary center.
Study Design: Retrospective, observational case series
Methods: This is a case series of six eyes undergoing hemi-circle shaped DMEK grafts at the University of Ottawa Eye Institute. Hemi-circle grafts were created by equally dividing an 11.0 mm manually trephined graft. The patient’s best-corrected visual acuity (BCVA) and endothelial cell density (ECD) were evaluated up to 27 months postoperatively. Intraoperative and postoperative complications were also assessed.
Results: The median age of patient was 78 years, with follow up ranging from 18 to 27 months. Hemi-DMEK was successful in 5 out of 6 eyes; one eye had persistent graft detachment and corneal edema despite re-bubbling. The patient underwent repeat DMEK at 2 months postoperatively. All 5 successful grafts cleared within 6 months, and had BVCA greater than 20/40 at the latest follow up (range 18 to 27 months). Compared to preoperative measurements, average central ECD decreased by 58% (range: 0.5% to 85% decrease) at final follow up.
Conclusions: This case series highlights that hemi-DMEK is a feasible method to increase availability of donor cornea with stable visual outcomes up to two years.