Off-Centered DMEK Grafts: Impact and Resolution.

Autor:	Romano V; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy., Airaldi M; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.; St. Paul's Eye Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom., Romano D; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy., Miglio F; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy., Borgia A; St. Paul's Eye Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom., Parekh M; Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA; and., Semeraro F; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy., Pereira NC; Department of Ophthalmology, Sorocaba Eye Hospital, Sorocaba, Brazil.
Jazyk:	angličtina
Zdroj:	Cornea [Cornea] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI:	10.1097/ICO.0000000000003745
Abstrakt:	Purpose: The aim of this study was to assess the outcomes of off-centered Descemet membrane endothelial keratoplasty (DMEK) grafts compared to descemetorhexis. Methods: This is a retrospective case series of DMEK procedures conducted between June 2022 and July 2023 with postoperative graft decentration, characterized by a gap between the graft and descemetorhexis edge. Results: Eight eyes of 8 patients met the inclusion criteria. The average gap between the descemetorhexis edge and DMEK graft was 911.2 μm (range 306-1468). The resulting focal peripheral edema overlying the gap resolved in all cases, with a median time of 3 months. Best-corrected visual acuity improved from 0.49 (±0.26) logarithm of the minimum angle of resolution to 0.01 (±0.02) logarithm of the minimum angle of resolution at 12 months (P = 0.003). Central corneal thickness decreased from 646.5 (±177.8) μm to 473.7 (±29.6) μm at 12 months (P = 0.05). One eye, in the overlapped area of host-donor Descemet membranes, had small peripheral partial graft detachment less than one-third of graft surface area. No eyes required graft rebubbling. A larger descemetorhexis to DMEK gap showed a trend toward longer resolution times (P = 0.06). Focal edema in the inferonasal periphery took longer to recover compared with the nasal position (P = 0.01). Larger descemetorhexis to DMEK gaps did not significantly influence the longitudinal visual acuity trend (P = 0.75). Conclusions: Decentered DMEK, characterized by a gap between the graft and descemetorhexis edge, leads to focal stromal edema that diminishes over time, with no impact on final visual acuity. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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