Three-Year Outcomes of Tri-Folded Endothelium-In Descemet Membrane Endothelial Keratoplasty With Pull-Through Technique
| Autor: | Luigi De Rosa, Sergiu Socea, Rossella Spena, James Myerscough, Cristina Bovone, Angeli Christy Yu, Massimo Busin, Luca Furiosi, Fiorella Fusco |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Visual acuity genetic structures Descemet membrane Endothelium air tamponade Visual Acuity Cell Count NO 03 medical and health sciences Postoperative Complications 0302 clinical medicine Pull-through technique Ophthalmology medicine Humans cell loss Descemet Membrane Aged 030304 developmental biology Aged 80 and over 0303 health sciences business.industry Endothelium Corneal Fuchs' Endothelial Dystrophy Graft Survival sulfur-hexafluoride SF6 Corneal Endothelial Cell Loss Middle Aged penetrating keratoplasty sulfur-hexafluoride SF6 cystoid macular edema penetrating keratoplasty air tamponade cell loss Tissue Donors Endothelial cell density Treatment Outcome medicine.anatomical_structure 030221 ophthalmology & optometry Bullous keratopathy Female medicine.symptom Complication business Descemet Stripping Endothelial Keratoplasty Fuchs Endothelial Corneal Dystrophy cystoid macular edema Follow-Up Studies |
| Popis: | To assess the 3-year outcomes of tri-folded endothelium-in Descemet membrane endothelial keratoplasty (DMEK) using bimanual pull-through delivery technique.Interventional case series.In this single-center study, we included 153 consecutive eyes that underwent DMEK for various indications (Fuchs endothelial corneal dystrophy [FECD]: n = 111; bullous keratopathy [BK]: n = 24; and failed graft: n = 18). DMEK grafts were loaded into a disposable cartridge in a tri-folded, endothelium-in configuration and delivered using bimanual pull-through technique. Main outcome measures were graft preparation and unfolding times, best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), and graft survival.Mean graft preparation time was 5.9 ± 1.1 minutes; and mean graft unfolding time was 2.9 ± 0.9 minutes. Excluding eyes with comorbidities, logarithm of minimum angle of resolution BSCVA improved significantly from baseline preoperative values of 0.92 ± 0.58 to 0.02 ± 0.07 at 1 year (P.001) and remained stable up to 3 years. Mean postoperative ECD decreased significantly (P.001) from eye bank values to 1,818 ± 362, 1,675 ± 372, and 1,580 ± 423 cells/mmTri-folded endothelium-in DMEK requires minimal time for graft unfolding, which is the surgical step considered most challenging by corneal surgeons. Visual outcomes and complication rates are not adversely affected by the modification of the surgical technique. |
| Databáze: | OpenAIRE |
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