Development of a Nomogram to Predict Graft Survival After Descemet Stripping Endothelial Keratoplasty

Cornea ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elliot Cherkas ◽  
Yasin Cinar ◽  
Qiang Zhang ◽  
James Sharpe ◽  
Kristin M. Hammersmith ◽  
...  
Keyword(s):  
Graft Survival ◽  
Endothelial Keratoplasty ◽  
Descemet Stripping Endothelial Keratoplasty

scholarly journals Femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty: 2-year outcomes of endothelial cell loss and graft survival

2021 ◽  
Author(s):  
Ting Wang ◽  
Peiyan Shi ◽  
Fengjie Li ◽  
Hua Gao ◽  
Suxia Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Endothelial Dysfunction ◽  
Femtosecond Laser ◽  
Graft Survival ◽  
Cell Loss ◽  
Endothelial Keratoplasty ◽  
Endothelial Cell Loss ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Graft Thickness

Abstract Purpose To assess 2-year endothelial cell loss and graft survival after femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty (FLS-DSEK). Methods In this prospective and noncomparative study carried out at Eye Hospital of Shandong First Medical University, 85 eyes (84 patients) with endothelial dysfunction receiving FLS-DSEK (n=62, 75.9%) or FLS-DSEK combined with phacoemulsification cataract surgery and intraocular lens implantation (n=23, 27.1%) from 2013 through 2016 were included. The graft endothelial cell loss, endothelial graft thickness, visual acuity, and complications after surgery were evaluated. Results Thin endothelial grafts were all successfully prepared, with no occurrence of perforation. The rate of endothelial cell loss was 17.4%, 18.8%, 19.9%, and 26.7%, and the central graft thickness was 113±54 μm, 102±40 μm, 101±28 μm, and 96±23 μm at 3, 6, 12, and 24 months, respectively. The median best-corrected visual acuity was 0.4 logMAR (range, 0–2 logMAR) at 24 months, demonstrating a significant difference from that before surgery (2 logMAR; range, 0.2–3 logMAR) (T=187.5, P<.001). Partial graft dislocation was the most common postoperative complication, with an occurrence rate of 14% (n=12), and it was associated with an abnormal iris-lens diaphragm (r=.35, P<.001). The other complications included a high intraocular pressure (n=5, 6%), endothelial graft rejection (n=4, 5%), and pupillary block (n=1, 1%). Endothelial graft decompensation occurred in the two eyes, and 98% (n=83) of the grafts survived at 24 months. Conclusions Data of the study suggest that the treatment using FLS-DSEK seems to be promising and might be considered a feasible choice in patients with endothelial dysfunction. Trial registration 1. Date of registration: 2021-02-18 2. Trial registration number: ChiCTR2100044091 3. Registration site: https://www.chictr.org.cn/

Graft detachments in endothelial keratoplasty

2021 ◽  
pp. bjophthalmol-2020-318092
Author(s):  
Rashmi Deshmukh ◽  
Sridevi Nair ◽  
Darren Shu Jeng Ting ◽  
Tushar Agarwal ◽  
Jacqueline Beltz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preventive Measures ◽  
Endothelial Keratoplasty ◽  
Common Complication ◽  
Prevention Measures ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Secondary Interventions ◽  
Different Types ◽  
Incidence Risk ◽  
Donor Graft

Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft. Management of a detached graft involves secondary interventions such as rebubbling, suturing and regrafts. In this review, we discuss graft detachment in different types of endothelial keratoplasty techniques including Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty; with emphasis on incidence, risk factors, preventive measures and their management.

Influence of Early Descemet Stripping Endothelial Keratoplasty on Visual Outcomes in Pseudophakic Corneal Edema

2016 ◽  
Vol 172 ◽  
pp. 58-63 ◽  
Author(s):  
Sarah B. Weissbart ◽  
Kristin M. Hammersmith ◽  
Brandon D. Ayres ◽  
Christopher J. Rapuano ◽  
Parveen K. Nagra ◽  
...  
Keyword(s):  
Corneal Edema ◽  
Endothelial Keratoplasty ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Visual Outcomes

Experimental rationale for using a viscoprotection of the corneal endothelium on the graft formed with a femtosecond laser for the descemet stripping endothelial keratoplasty

2021 ◽  
pp. 94-96
Author(s):  
I.S. Tkachenko ◽  
◽  
B.E. Malyugin ◽  
S.A. Borzenok ◽  
D.S. Ostrovskiy ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Femtosecond Laser ◽  
Corneal Endothelium ◽  
Hydroxypropyl Methylcellulose ◽  
Lamellar Keratoplasty ◽  
Confocal Laser ◽  
Control Group ◽  
Endothelial Keratoplasty ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Experimental Group

Purpose. To rationale experimentally the use of a viscoprotection of the corneal endothelium on the graft formed with a femtosecond laser for the descemet stripping endothelial keratoplasty. Material and methods. In our study, we used 12 pig's corneoscleral discs. The preservation time before the experiment averaged 12±4 hours. The corneas were divided into 2 groups. In the operating room, the graft was formed using an LDV Z8 femtosecond laser (Ziemer, Switzerland) from the endothelial side. Before applanation of the donor cornea and femtolaser head, a 1% solution of hydroxypropyl methylcellulose (HPMC) was applied to the endothelium - experimental group. The control group was appraised according to the standard technique, with the application of a few drops of a solution for storing the corneas. Then the applanation was monitored and evaluated by laser optical coherence tomography. Then the graft was separated from the bed and transferred to a conservation medium. Under laboratory conditions, to determine the viability of endothelial cells, the graft was stained with a «vital» dye with the commercial name Life and Dead (Abcam, UK) and placed in a confocal laser scanning microscope. Endothelial cells were counted using the ImageJ software. Results. In the experimental and control groups, the number of living endothelial cells (EC) was 91.06±1.49% and 83.86±2.14%, respectively (p<0.001). The number of dead ECs in the control group was 7.2±0.65% more than in the experimental group and amounted to 16.14±2.14% and 8.94±1.49%, respectively (p<0.001). Conclusion. The study demonstrated that the use of viscoprotection of the corneal graft endothelium for posterior lamellar keratoplasty is quite effective, and significantly reduces the loss of EC at the stage of cutting out the graft with a femtosecond laser. Key words: descemet stripping endothelial keratoplasty, femtosecond laser, vital dyes.

scholarly journals Descemet stripping endothelial keratoplasty: One-year follow-up

2010 ◽  
Vol 138 (11-12) ◽  
pp. 690-693
Author(s):  
Ljubisa Nikolic ◽  
Vesna Jovanovic
Keyword(s):  
Corneal Thickness ◽  
Long Term Results ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Air Bubble ◽  
Primary Graft Failure ◽  
Internal Side ◽  
One Year

Introduction. Sutureless transplantation of endothelium on a thin stromal carrier was introduced under the name of Descemet stripping endothelial keratoplasty (DSEK) in 2004. It has become the treatment of choice of corneal oedema due to endothelial dysfunction. Objective. To investigate posterior lamellar graft attachment, central corneal thickness (CCT), astigmatism, and best corrected visual acuity (BCVA) during one-year follow-up. Methods. Surgery was performed on one eye of 11 patients with pseudophakic bullous keratopathy and Fuchs? dystrophy. The graft thick 150-200 ?m and 8.0 mm in diameter was detached manually. The carrier of the recipient cornea was created by DSEK. The graft was folded in half, introduced into the anterior orbital chamber through a 5.0 mm cut on the limbus and attached by air bubble along the internal side of the recipient cornea. CCT and astigmatism were evaluated by corneal topography, and graft attachment by biomicroscopy. Results. One year after surgery, all grafts remained attached. Primary graft failure occurred in three eyes, probably due to the crushing effect of the forceps. BCVA was 20/30 (2 eyes), and 20/40 (6 eyes), CCT 643-728 ?m, and astigmatism 1.1 D to 2.9 D. The peak values were reached three months after surgery, and did not change much afterwards. Conclusion. This is the first report on the long-term results of DSEK in our literature. The results are similar to those obtained by more experienced DSEK surgeons, and suggest that this procedure is safe and successful.

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