Management of Upside-Down Descemet Membrane Endothelial Keratoplasty: A Case Series.

Autor:	Bardan AS; Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt, United Kingdom.; Brighton and Sussex Medical School, Brighton, United Kingdom.; Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom., Goweida MB; Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt, United Kingdom., El Goweini HF; Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt, United Kingdom., Liu CS; Brighton and Sussex Medical School, Brighton, United Kingdom.; Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.; Tongdean Eye Clinic, Hove, United Kingdom.
Jazyk:	angličtina
Zdroj:	Journal of current ophthalmology [J Curr Ophthalmol] 2020 Apr 30; Vol. 32 (2), pp. 142-148. Date of Electronic Publication: 2020 Apr 30 (Print Publication: 2020).
DOI:	10.4103/JOCO.JOCO_102_20
Abstrakt:	Purpose: To present the management of upside-down Descemet membrane endothelial keratoplasty (DMEK) following combined phacoemulsification with DMEK (phaco-DMEK) in cases of Fuchs endothelial dystrophy (FED). Methods: This is a comparative interventional case series extracted from a prospective interventional case series (clinical outcome of DMEK combined with phacoemulsification for FED). We report five cases of upside-down DMEK. Two cases of upside-down DMEK were managed with re-orientation and the other two with repeat DMEK. The 5 th case underwent an initial re-orientation and then a subsequent repeat graft. Graft re-orientation and repeat surgery were performed 9-20 days after initial phaco-DMEK. All the five cases were followed up over a 6-month period, and the following outcomes were assessed: best corrected visual acuity (BCVA), contrast sensitivity (CS), central corneal thickness, endothelial cell density (ECD), and central macular thickness. Results: At the final 6-month postoperative follow-up, all the five cases achieved good outcomes in terms of BCVA and CS. Overall, the results were comparable to 32 control cases. One case of re-orientation and the case of re-orientation with subsequent repeat DMEK performed slightly less well than control cases in terms of postoperative ECD. Conclusions: Re-orientation of the original DMEK scroll in cases of upside-down DMEK can be a safe and cost-effective alternative to repeat DMEK. If re-orientation does not result in corneal deturgescence, a repeat DMEK may be done subsequently. Competing Interests: There are no conflicts of interest. (Copyright: © 2020 Journal of Current Ophthalmology.)
Databáze:	MEDLINE
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