Predictive factors of graft detachment and rebubbling after descemet membrane endothelial keratoplasty.
Autor: | Guindolet D; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France., Disegni H; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France., Martin GC; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France., Azar G; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France., Hardy S; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France., Cochereau I; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France.; Ophthalmology Department, Bichat Claude-Bernard Hospital, Paris, France.; Université de Paris, Paris, France., Gabison EE; Ophthalmology Department, Rothschild Foundation Hospital, 25-29 Rue Manin, 75019, Paris, France. egabison@for.paris.; Ophthalmology Department, Bichat Claude-Bernard Hospital, Paris, France. egabison@for.paris.; Université de Paris, Paris, France. egabison@for.paris. |
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Jazyk: | angličtina |
Zdroj: | International ophthalmology [Int Ophthalmol] 2023 May; Vol. 43 (5), pp. 1511-1521. Date of Electronic Publication: 2022 Dec 03. |
DOI: | 10.1007/s10792-022-02547-4 |
Abstrakt: | Purpose: To identify risk and predictive factors associated with the need of rebubbling in the eye of patients who underwent a descemet membrane endothelial keratoplasty (DMEK). Methods: The records of patients who underwent DMEK were retrospectively analyzed. Data regarding comorbidities, intraoperative characteristics, and postoperative treatments or complications were collected. The central corneal thickness (CCT) was measured by optical coherence tomography before and the day after DMEK. Univariate and multivariate analyses were performed. Results: Of the 333 DMEK, rebubbling was performed in 119 cases (36%). Preoperative subepithelial fibrosis and a history of penetrating keratoplasty (PK) were associated with significantly more graft detachment [OR of 3.55 (2.02-6.32; P < 0.001) and 5.89 (2.00-21.86; P = 0.003), respectively]. A decreased CCT the day after surgery reduced by 5.7-fold the risk of rebubbling (sensitivity/specificity of 0.42/0.93). Conversely, a 20% increase in the CCT the day after surgery increased by 4.5-fold the risk of rebubbling (sensitivity/specificity of 0.42/0.91). Conclusion: Variation of the CCT could be used as a predictive factor of rebubbling after DMEK. Patients with a 20% increase of CCT the day after surgery are at higher risk of graft detachment. Conversely, a reduced CCT the day after the surgery is associated with a reduced risk of rebubbling. Subepithelial fibrosis and history of PK were also identified as risk factors for rebubbling. Those predictive factors may help develop a customized approach for patients undergoing DMEK surgery. (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.) |
Databáze: | MEDLINE |
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