Double trouble in DMEK surgery: Learning experience and review of the literature.

Autor:	Romano V; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.; Ophthalmic Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italia., Passaro ML; Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples 'Federico II', Naples, Italy.; Department of Medicine and Health Sciences 'V. Tiberio', University of Molise, Campobasso, Italy., Airaldi M; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK., Ancona C; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Pagano L; St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK., Semeraro F; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.; Ophthalmic Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italia., Pineda R; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
Jazyk:	angličtina
Zdroj:	European journal of ophthalmology [Eur J Ophthalmol] 2024 May; Vol. 34 (3), pp. NP22-NP28. Date of Electronic Publication: 2024 Feb 22.
DOI:	10.1177/11206721241228346
Abstrakt:	Purpose: To report a challenging Descemet Membrane Endothelial Keratoplasty (DMEK) case, complicated by intraoperative aqueous misdirection and spontaneous anterior chamber fibrin reaction. Methods: A 70-year-old female affected by corneal edema due to Fuchs endothelial dystrophy underwent a triple procedure (cataract extraction - IOL implantation - DMEK surgery) in her left eye. This report illustrates the management of the intraoperative complications of aqueous misdirection syndrome and anterior chamber fibrin reaction. Results: Despite the optimal management of the posterior pressure and the thorough removal of the fibrinous reaction during the case, the DMEK graft was not completely unfolded and centred at the end of the surgical procedure. Nonetheless, the patient showed good long-term anatomical and functional recovery: at the last follow-up (2 years after surgery), central corneal thickness was 526 µm with a best corrected visual acuity of 20/25 and an endothelial cell density of 1112 cell/mm 2 . Conclusion: Early recognition and prompt management of intraoperative aqueous misdirection syndrome and anterior chamber fibrin reaction during DMEK surgery is essential to ensure good functional and anatomical outcomes. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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