Quarter-Descemet Membrane Endothelial Keratoplasty: One- to Two-Year Clinical Outcomes
| Autor: | Gerrit R. J. Melles, Isabel Dapena, Silke Oellerich, Rénuka S. Birbal, Lisanne Ham, Vincent J A Bourgonje, Lamis Baydoun, Sorcha Ní Dhubhghaill |
|---|---|
| Přispěvatelé: | Ophtalmology - Eye surgery |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity genetic structures Descemet membrane Corneal Pachymetry Visual Acuity Cell Count DMEK 03 medical and health sciences 0302 clinical medicine Ophthalmology medicine Humans Prospective Studies Aged Aged 80 and over business.industry endothelial cell density Endothelium Corneal Fuchs' Endothelial Dystrophy Outcome measures Middle Aged eye diseases Tissue Donors corneal transplantation Endothelial cell density Treatment Outcome 030221 ophthalmology & optometry Referral center Female Human medicine sense organs medicine.symptom business 030217 neurology & neurosurgery Fuchs Endothelial Corneal Dystrophy Descemet Stripping Endothelial Keratoplasty Follow-Up Studies |
| Zdroj: | Cornea, 39(3), 277-282. LIPPINCOTT WILLIAMS & WILKINS Cornea |
| ISSN: | 1536-4798 0277-3740 |
| Popis: | Purpose:To report clinical outcomes of the first Quarter-Descemet membrane endothelial keratoplasty (Quarter-DMEK) case series performed for central Fuchs endothelial corneal dystrophy.Methods:This is a prospective, interventional case series analyzing the clinical outcomes of 19 eyes of 19 patients with central Fuchs endothelial corneal dystrophy, that is, with guttae predominantly in the 6- to 7-mm optical zone, who underwent unilateral Quarter-DMEK at a tertiary referral center. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), and postoperative complications. Included eyes had up to 2 years of postoperative follow-up.Results:At 6 months postoperatively, all eyes reached a BCVA of >= 20/40 (>= 0.5): 18 of 19 eyes (95%) with >= 20/25 (>= 0.8) and 9 of 19 eyes (42%) with >= 20/20 (>= 1.0). Thereafter, BCVA remained stable up to 2 years postoperatively. The mean donor ECD decreased from 2842 139 cells/mm(2) (n = 19) before implantation to 913 +/- 434 cells/mm(2) (-68%) at 6 months (n = 19), 869 +/- 313 cells/mm(2) (-70%) at 12 months (n = 18), and 758 +/- 225 cells/mm(2) (-74%) at 24 months (n = 13) after Quarter-DMEK. Visually significant graft detachment requiring rebubbling occurred in 8 of 19 eyes (42%).Conclusions:Quarter-DMEK surgery yields visual outcomes similar to those of conventional DMEK and may potentially quadruple the availability of endothelial grafts. Further modifications of the graft preparation and the surgical technique may improve clinical outcomes in terms of lower ECD decrease and fewer graft detachments. |
| Databáze: | OpenAIRE |
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