scholarly journals Effects of uncomplicated Descemet membrane endothelial keratoplasty on the central retinal thickness

2021 ◽  
Author(s):  
Tibor Lohmann ◽  
Sabine Baumgarten ◽  
Niklas Plange ◽  
Peter Walter ◽  
Matthias Fuest
Keyword(s):  
Risk Factors ◽  
Retinal Thickness ◽  
Bullous Keratopathy ◽  
Eye Drops ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Related Risk ◽  
Department Of Ophthalmology ◽  
Fuchs Endothelial Dystrophy

Abstract Purpose To determine retinal thickness (RT) changes and the incidence of macular edema after uncomplicated Descemet membrane endothelial keratoplasty (DMEK-ME) in patients without ME risk factors. Methods In this retrospective study, 107 pseudophakic eyes of 74 patients with Fuchs endothelial dystrophy (FED) (79.4%) or bullous keratopathy (BK) (20.6%) underwent DMEK surgery between 2016 and 2019 at the Department of Ophthalmology, RWTH Aachen University. Patients with intra- or postoperative complications as well as pre-existing risk factors for ME were excluded. Macular spectral-domain optical coherence tomography (SD-OCT) and best spectacle-corrected visual acuity (BSCVA) measurements were performed before, 1 week, 1 month, and 6 months after surgery. Retinal thickness (RT) was analyzed in the central foveal 1 mm (CSF), parafoveal 3 mm and 6 mm subfield. Results Eight eyes (7.5%) developed DMEK-ME 1 month after surgery. Six DMEK-ME eyes (75%) were rebubbled, compared with 31.3% (31 of 99; P = 0.02) of the non DMEK-ME eyes. DMEK-ME eyes had a significantly thicker CSF 1 month after surgery (432.0 ± 97.6 μm) compared with non-DMEK-ME eyes (283.7 ± 22.2 μm; P = 0.01). The other subfields and time points showed no significant RT changes. DMEK-ME significantly impaired BSCVA (0.38 ± 0.92 logMAR) only 1 month after surgery in comparison to the non DMEK-ME eyes (0.23 ± 0.87 logMAR, P = 0.015). Conclusion Excluding systemic and surgery-related risk factors, rebubbling increases the risk of DMEK-ME. Performing a CSF scan 1 month after surgery, particularly in rebubbled eyes, efficiently detects DMEK-ME and allows the prompt initiation of treatment, e.g., topical corticosteroid and non-steroidal (NSAID) eye drops.

scholarly journals Risk Factors for Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Cornea ◽  
2019 ◽  
Vol 38 (7) ◽  
pp. 820-824 ◽  
Author(s):  
Satoru Inoda ◽  
Takahiko Hayashi ◽  
Hidenori Takahashi ◽  
Itaru Oyakawa ◽  
Hideaki Yokogawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane

scholarly journals Corneal transplantation activity in Catalonia, Spain, from 2011 to 2018: Evolution of indications and surgical techniques

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249946
Author(s):  
Noelia Sabater-Cruz ◽  
Marc Figueras-Roca ◽  
Lydia Padró-Pitarch ◽  
Jaume Tort ◽  
Ricardo P. Casaroli-Marano
Keyword(s):  
Corneal Transplantation ◽  
Surgical Techniques ◽  
Annual Reports ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Eye Bank ◽  
Increasing Trend ◽  
Fuchs Endothelial Dystrophy

Purpose To report corneal transplant activity carried out in Catalonia (Spain) and the evolving indications for keratoplasty over an 8-year period. Methods Annual reports from the Catalan Transplant Organization, Spain, on corneal graft indications and techniques from 2011 to 2018 were reviewed. Results A total of 9457 keratoplasties were performed in Catalonia, from January 2011 to December 2018. The most frequent indications were bullous keratopathy (BK; 20.5%), Fuchs endothelial dystrophy (FED; 17.9%), re-graft (13.7%), and keratoconus (11.3%). Penetrating keratoplasty (PKP) accounted for 63.4% of all performed keratoplasties. Since the introduction of eye bank precut tissue for Descemet stripping automated endothelial keratoplasty (DSAEK) in 2013 and for Descemet membrane endothelial keratoplasty (DMEK) in 2017 the number of endothelial keratoplasties has drastically increased. An increasing trend of posterior lamellar techniques over the total of keratoplasties was found (p<0.001). Endothelial keratoplasties for different endothelial diseases indications (BK, FED, and re-graft), also showed and increasing trend (p<0.001). DMEK is the technique with the highest increase (statistically significantly different from linearity) over other endothelial keratoplasties in FED (p<0.001) but not in BK (p = 0.67) or re-grafts (p = 0.067). Conclusion Endothelial diseases represented the top indication for keratoplasty over the 8-year period. PKP is still the most used technique in Catalonia, but endothelial keratoplasties and especially DMEK showed a significant increasing trend over the last years. This is congruent with the main rationale nowadays for keratoplasties: to customize and transplant as less tissue as possible. Therefore, the availability of precut tissue could have definitely enforced such approach.

Cystoid macular oedema after descemet membrane endothelial keratoplasty

2021 ◽  
pp. bjophthalmol-2021-319455
Author(s):  
Damien Guindolet ◽  
Odile Huynh ◽  
Gilles C Martin ◽  
Hugo Disegni ◽  
Georges Azar ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Univariate Analysis ◽  
Cystoid Macular Oedema ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Spectral Domain Oct ◽  
History Of ◽  
Clinically Significant

AimsTo determine the incidence and risk factors of cystoid macular oedema (CMO) following descemet membrane endothelial keratoplasty (DMEK) with or without combined cataract surgery (triple-DMEK).MethodsWe reviewed the records of patients who underwent DMEK surgery alone or triple-DMEK performed at the Rothschild Foundation Hospital (Paris, France) between January 2019 and March 2020. Patients with pre-existing CMO observed on the preoperative macular optical coherence tomography (OCT) were excluded. Spectral-domain OCT was performed in patients with postoperative visual impairment. Data regarding comorbidities, intraoperative characteristics and postoperative treatments or complications were collected and analysed. Univariate and multivariate analyses were performed.ResultsTwenty three of 246 eyes (9.36%) developed clinically significant (cs)-CMO after DMEK. Triple-DMEK was not associated with a higher risk to develop CMO (12.2% in DMEK alone and 6.1% in triple-DMEK). Pseudophakic bullous keratopathy (PBK ; 39.1% vs 9%; OR=3.5 (1.0 to 11.8), p=0.045) and epiretinal membrane (ERM; 39.1% vs 7.7%; OR=10.5 (3.4 to 32.3), p<0.001) were more frequently observed in patients who developed CMO. The occurrence of hyphaema during surgery was statistically associated with postoperative CMO (13% vs 1.3%; OR=7.1 (1.0 to 48.8) p=0.045). Peroperative epithelial debridement was statistically associated with postoperative CMO (65.2% vs 33.2%, p=0.005), but only in univariate analysis.ConclusionsWe identified a clinically significant CMO incidence of 9.35% after DMEK. Patients with a history of ERM, PBK and intraoperative hyphaema may be at risk of developing CMO after DMEK surgery and should be monitored.

Case Report of Quarter–Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Dystrophy

Cornea ◽  
2017 ◽  
Vol 36 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Thomas M. Müller ◽  
Itay Lavy ◽  
Lamis Baydoun ◽  
Jessica T. Lie ◽  
Isabel Dapena ◽  
...  
Keyword(s):  
Case Report ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Fuchs Endothelial Dystrophy

scholarly journals Risk factors for endothelial cell loss after Descemet membrane endothelial keratoplasty (DMEK)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Takahiko Hayashi ◽  
Silvia Schrittenlocher ◽  
Sebastian Siebelmann ◽  
Viet Nhat Hung Le ◽  
Mario Matthaei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endothelial Cell ◽  
Cell Loss ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Endothelial Cell Loss ◽  
Descemet Membrane

scholarly journals Comparison of ACIOL Exchange and Descemet Membrane Endothelial Keratoplasty with ACIOL Retention and Descemet Stripping Automated Endothelial Keratoplasty in the Setting of Pseudophakic Bullous Keratopathy

2021 ◽  
Author(s):  
Biana Dubinsky-Pertzov ◽  
Gissela Santaella ◽  
Nir Sorkin ◽  
Lior Or ◽  
Inbal Gazit ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Graft Failure ◽  
Good Alternative ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Exchange Group ◽  
Retention Group ◽  
Demographical Data

Abstract Objective: To compare the clinical outcomes and complications of anterior chamber intraocular lens (ACIOL) exchange and Descemet membrane endothelial keratoplasty (DMEK) with ACIOL retention and Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with PBK.Methods: A multicenter retrospective cohort study. Patients with ACIOL who underwent endothelial keratoplasty procedure due to PBK between 2012-2018 in two tertiary medical centers, were identified. Clinical and demographical data including preoperative and postoperative characteristics were collected.Results: Thirteen eyes in the “DMEK and ACIOL exchange” group and 15 in the “DSAEK and ACIOL retention” group were included in the analysis. Mean BCVA six months postoperatively was 0.51±0.20 LogMAR (Snellen 20/64) and 0.57±0.22 LogMAR (Snellen 20/83) in the “DMEK and ACIOL exchange” group and “DSAEK and ACIOL retention” group, respectively (P=0.38). Graft failure occurred in 6 eyes (40%) in the “DSAEK and ACIOL retention” group; four of them were secondary failures occurring at an average follow-up time of 15±11.9 months. In the “DMEK and ACIOL exchange” group, graft failure occurred in one eye and was a primary failure (P=0.046). In the “DMEK and ACIOL exchange” group, postoperative complications were seen in 4 eyes (30.7%). No postoperative complications were recorded in the “DSAEK and ACIOL retention” group (P=0.035).Conclusion: Despite the lower complication rate, the higher incidence of graft failure and the need for second keratoplasty in the DSAEK group along with the similar visual outcomes, might suggest that in the indication of PBK, ACIOL exchange with DMEK offers a good alternative to ACIOL retention with DSAEK.

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