Descemet membrane endothelial keratoplasty after penetrating keratoplasty
| Autor: | José L. Güell, Felicidad Manero, Daniel Elies, Oscar Gris, Merce Morral, Miriam Barbany |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Corneal endothelium Graft failure Distance visual acuity genetic structures Descemet membrane business.industry Corneal Transplant Fuchs' dystrophy medicine.disease Cell loss Endothelial cell density 03 medical and health sciences 0302 clinical medicine Ophthalmology 030221 ophthalmology & optometry medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of EuCornea. 2:10-13 |
| ISSN: | 2452-4034 |
| DOI: | 10.1016/j.xjec.2019.03.003 |
| Popis: | Purpose To describe visual and clinical outcomes of descemet membrane endothelial keratoplasty (DMEK) for late endothelial failure after penetrating keratoplasty (PK). # Methods Retrospective, observational study of patients who consecutively received DMEK to treat PK graft failure. Intraoperative complications were recorded. Our previously described DMEK surgical technique was used except that host descemet membrane was not stripped in any of the eyes. Corrected distance visual acuity (CDVA), and endothelial cell density (ECD) were evaluated before surgery and at regular intervals up to 24 months after the surgery. # Results Twenty-six eyes of 26 patients were included. Mean host age was 58.50 ± 12.50 years old. Mean donor age was 65.30 ± 10.49. Mean follow up after DMEK was 23.08 ± 10.27 (range 6 months–48 months). Seventeen (65.38%) eyes reached at least the 24-month follow up time point. At last follow up, 24 eyes (92.31%) presented with clear corneas. Twenty-four months postoperatively, mean Snellen CDVA in decimal fraction was 0.75 ± 0.03 (range 0.6–0.80) and mean central endothelial cell density was 1480.41 ± 320.56 cells/mm2 (range, 591–1950 cells/mm2). Mean cell loss at 6 months was 27.67 ± 16.03%. Three (11.53%) eyes had significant graft detachment that required re-bubbling. No episodes of immunological graft rejection were documented. # Conclusions Our experience shows that DMEK is a useful technique to treat endothelial graft failure following PK. Compared to repeat PK, DMEK-specific surgical complications and postsurgical management should be expected. |
| Databáze: | OpenAIRE |
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