Enhancing Descemet Membrane Endothelial Keratoplasty in Postvitrectomy Eyes With the Use of Pars Plana Infusion

Autor: Armand Borovik, Clara C. Chan, Mahmood Showail, Nir Sorkin, David S. Rootman, Murad Alobthani, Adi Einan-Lifshitz, Tanguy Boutin, Zach Ashkenazy
Rok vydání: 2016
Předmět:
Male
Pars plana
medicine.medical_specialty
Visual acuity
Supine position
genetic structures
Descemet membrane
Anterior Chamber
medicine.medical_treatment
Visual Acuity
Cell Count
Vitrectomy
Acetates
Sodium Chloride
Artificial Lens Implant Migration
Corneal Diseases
Eye injuries
03 medical and health sciences
0302 clinical medicine
Ophthalmology
Supine Position
medicine
Humans
Infusions
Parenteral
Intraoperative Complications
Aged
Retrospective Studies
Minerals
business.industry
Endothelium
Corneal
Graft Survival
Retinal Detachment
Retinal detachment
Corneal Endothelial Cell Loss
medicine.disease
Eye Injuries
Penetrating
eye diseases
Drug Combinations
medicine.anatomical_structure
Descemet Stripping Endothelial Keratoplasty
030221 ophthalmology & optometry
Female
sense organs
medicine.symptom
business
030217 neurology & neurosurgery
Zdroj: Cornea. 36:280-283
ISSN: 0277-3740
Popis: Purpose To present a modified surgical technique to perform Descemet membrane endothelial keratoplasty (DMEK) in previously vitrectomized eyes and to analyze its safety and efficacy. Methods A retrospective analysis of previously vitrectomized eyes that underwent DMEK at Toronto Western Hospital was performed. The modified DMEK technique that was used included placement of a posterior pars plana infusion to reduce fluctuations in the anterior chamber depth and its excessive deepening. Results Twelve eyes of 12 patients (5 females and 7 males) aged 65.3 ± 21.5 years were included. Mean best-corrected visual acuity improved significantly from 1.72 ± 0.62 logMAR (mean Snellen ∼20/1040) preoperatively to 1.01 ± 0.64 logMAR (mean Snellen ∼20/200) at 6 months postoperatively (P = 0.017). Mean donor endothelial cell density was 2658 ± 229 cells/mm preoperatively and 1732 ± 454 cells/mm at 6 months after the procedure (mean percentage cell loss of 31.8%) (P = 0.046). There were no significant intraoperative complications, and no graft failures. One eye had graft detachment, which resolved after 2 rebubbling procedures. One eye had retinal detachment, which was corrected surgically. Conclusions The use of posterior pars plana infusion in previously vitrectomized eyes stabilizes the anterior segment during DMEK, allowing for performance of DMEK surgery, and can potentially reduce intraoperative and postoperative complications.
Databáze: OpenAIRE
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