Descemet membrane anterior keratoplasty using a decellularized Descemet membrane allograft achieved complete epithelialization in 84.8% of patients with nonhealing ocular surface disease, with median healing occurring within 28 days, according to a study published in Cornea. The researchers reviewed surgeons’ survey responses from 15 surgeons pertaining to the postoperative outcomes of Descemet membrane anterior keratoplasty (DMAK) surgeries using BrightMEM (Brightstar Therapeutics) corneal allografts, which were placed during a 3-year period. Cases with fewer than 60 days of follow-up or without evidence of underlying ocular surface disease were excluded. Outcomes assessed included epithelialization rates, healing time, and change in visual acuity.

Among the 99 included cases performed by surgeons across the United States, complete epithelialization occurred in 84.8% of patients, with a median healing time of 28 days. Graft retention was reported in 91.9% of cases. Healing outcomes differed by ocular surface disease subtype. Healing rates and median healing time were 89.4% and 30 days for subtotal limbal stem cell deficiency cases (n=47); 78% and 34 days for persistent epithelial defect cases (n=41); and 79.5% and 30.5 days for neurotrophic keratopathy cases (n=44). Longer-term follow-up suggested durable outcomes. Among 35 patients observed for more than 6 months, complete healing was achieved in 97.1% of cases.

Pain outcomes also improved after surgery. For those with available follow-up for more than 12 months (n=10), 100% maintained a healed surface. Nineteen patients (33%) reported pain preoperatively, and all reported improvement or resolution, with mean pain scores decreasing from 5.47 to 0.84 at follow-up. Visual acuity improved in 52.6% of cases. No infectious complications attributable to the tissue were reported.

The researchers noted that transplantation using the BrightMEM corneal allograft represents an innovative technique for treating nonhealing ocular surface diseases, including persistent epithelial defects and limbal stem cell deficiency.

“The durability of DM as a substrate for ocular surface reconstruction makes DMAK with BrightMEM corneal allograft a promising option when other nonsurgical treatments fail,” the authors wrote. “Further prospective studies are warranted to establish the long-term efficacy and safety of this technique.”