ArticleOphthalmology2026
Factors Associated with Successful Descemet Membrane Endothelial Keratoplasty in the Diabetes Endothelial Keratoplasty Study.
Article in Ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05134480 (Diabetes Endothelial Keratoplasty Study), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diabetes Endothelial Keratoplasty Study (DEKS): Impact of Diabetes on Corneal Transplant Success and Endothelial Cell Loss
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Authors and funding
18 authors.
Funding
Abstract
objectiveTo identify donor, lenticule preparation, recipient, and operative factors associated with 1-year Descemet membrane endothelial keratoplasty (DMEK) success in the Diabetes Endothelial Keratoplasty Study (DEKS).
designThis prospective cohort study was a prespecified secondary analysis of the DEKS randomized, double-masked, multicenter clinical trial.
participantsIndividuals undergoing DMEK to treat corneal endothelial dysfunction at 28 clinical sites.
methodsRecipient eyes were randomized to receive a cornea from a donor without or with diabetes in a 2:1 ratio. Details about donor, tissue preparation, recipient, and operative factors were recorded prospectively. The study excluded eyes with a prior penetrating keratoplasty or glaucoma tube shunt. Graft failures were classified as follows. If the recipient stroma was cloudy in the first postoperative week and did not clear or required a regraft within 8 weeks, it was classified as "primary donor failure" in the absence of operative complications or as "early failure" associated with operative complications. If the recipient stroma cleared in the first postoperative week or cleared after being cloudy in the first postoperative week and later required a regraft or became cloudy without clearing for 90 days, it was classified as "late failure." Proportional hazards and logistic regression were used to estimate risk ratios.
main outcome measuresGraft success at 1 year.
resultsOf 1421 DMEK grafts, 1374 (97%) were clear at 1 year, 32 were classified as primary donor failures, 12 as early failures, and 3 as late failures. In multivariate analysis, the 78 cases (5.5%) with operative complications had a lower success rate (89%; hazard ratio for graft failure 4.01; 95% confidence interval, 1.86-8.63; P < 0.001). Three additional factors were associated with slightly higher graft success rates without reaching the defined statistical significance threshold of P < 0.01: baseline donor endothelial cell density ≥2500 versus <2500 cells/mm
conclusionsDescemet membrane endothelial keratoplasty was highly successful across a wide range of donor, recipient, and surgical technique variations. Not surprisingly, graft success was lower in cases with operative complications. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
trial registrationNCT05134480, ClinicalTrials.gov.
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