A Case of Post-traumatic Corneal Endothelial Dysfunction Treated with Descemet’s Membrane Endothelial Keratoplasty Combined with Cataract Surgery

Abstract BacKground: To evaluate the clinical outcomes and features of Descemet’s membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX). Methods: In this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery about four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed. Results: This study included 14 eyes of 14 patients (PEX: n=6, FECD: n=8). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67 ± 0.28 at the preoperative point to 0.43 ± 0.14 at 1 month, 0.27 ± 0.10 at 3 months, and 0.19 ± 0.08 at 6 months after DMEK. The donor corneal ECD was 2,704 ± 225 cells/mm2 at the preoperative point and decreased to 1,691 ± 498 cells/mm2 at 1 month, 1,425 ± 366 cells/mm2 at 3 months, and 1,281 ± 340 cells/mm2 (52.7 ± 11.7% less than ECD of the donor graft) at 6 months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p=0.821); BSCVA (p=0.001) and the reduction rate of ECD (p=0.010) were relatively worse. Conclusions: DMEK is effective for the treatment of endothelial dysfunction due to PEX. Keywords: Descemet’s membrane endothelial keratoplasty, pseudoexfoliation syndrome, bullous keratopathy, endothelial keratoplasty

Download Full-text

Descemet’s Membrane Endothelial Keratoplasty for Pseudoexfoliation Syndrome: A Case Series

10.21203/rs.2.229/v3 ◽

2019 ◽

Author(s):

Saho Tase ◽

Toshiki Shimizu ◽

Takahiko Hayashi ◽

Hitoshi Tabuchi ◽

Koji Niimi ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Corneal Thickness ◽

Reduction Rate ◽

Case Series ◽

Corneal Dystrophy ◽

Pseudoexfoliation Syndrome ◽

Endothelial Keratoplasty ◽

Descemet’S Membrane Endothelial Keratoplasty ◽

Descemet's Membrane ◽

Descemet’S Membrane

Abstract Bachground: To evaluate the clinical outcomes and features of Descemet’s membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX). Methods: In this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery about four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed. Results: This study included 14 eyes of 14 patients (PEX: n=6, FECD: n=8). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67 ± 0.28 at the preoperative point to 0.43 ± 0.14 at 1 month, 0.27 ± 0.10 at 3 months, and 0.19 ± 0.08 at 6 months after DMEK. The donor corneal ECD was 2,704 ± 225 cells/mm2 at the preoperative point and decreased to 1,691 ± 498 cells/mm2 at 1 month, 1,425 ± 366 cells/mm2 at 3 months, and 1,281 ± 340 cells/mm2 (52.7 ± 11.7% less than ECD of the donor graft) at 6 months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p=0.821); BSCVA (p=0.001) and the reduction rate of ECD (p=0.010) were relatively worse. Conclusions: DMEK is effective for the treatment of endothelial dysfunction due to PEX.

Download Full-text

Descemet’s Membrane Endothelial Keratoplasty for Pseudoexfoliation Syndrome: A Case Series

10.21203/rs.2.229/v2 ◽

2019 ◽

Author(s):

Saho Tase ◽

Toshiki Shimizu ◽

Takahiko Hayashi ◽

Hitoshi Tabuchi ◽

Koji Niimi ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Corneal Thickness ◽

Reduction Rate ◽

Case Series ◽

Corneal Dystrophy ◽

Pseudoexfoliation Syndrome ◽

Endothelial Keratoplasty ◽

Descemet’S Membrane Endothelial Keratoplasty ◽

Descemet's Membrane ◽

Descemet’S Membrane

Abstract Background: To evaluate the clinical outcomes and features of Descemet’s membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX). Methods: In this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs’ endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery approximately four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed. Results: This study included 14 eyes of 14 patients (PEX: n=6, FECD: n=8). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67 ± 0.28 preoperatively to 0.43 ± 0.14 at 1 month, 0.27 ± 0.10 at 3 months, and 0.19 ± 0.08 at 6 months after DMEK. The donor corneal ECD was 2,704 ± 225 cells/mm2 preoperatively and decreased to 1,691 ± 498 cells/mm2 at 1 month, 1,425 ± 366 cells/mm2 at 3 months, and 1,281 ± 340 cells/mm2 (52.7 ± 11.7% less than ECD of the donor graft) at 6 months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p=0.821); BSCVA (p=0.001) and the reduction rate of ECD (p=0.010) were comparatively worse. Conclusions: DMEK is effective for the treatment of endothelial dysfunction due to PEX.

Download Full-text

The Effect of Combined Cataract Surgery on Graft Survival in Descemet's Membrane Endothelial Keratoplasty: A Comparative Clinical Study

Turkiye Klinikleri Journal of Ophthalmology ◽

10.5336/ophthal.2020-78329 ◽

2021 ◽

Vol 30 (3) ◽

pp. 155-162

Author(s):

Nilay KANDEMİR BEŞEK ◽

Ahmet KIRGIZ ◽

Semih ÇAKMAK ◽

Yusuf YILDIRIM

Keyword(s):

Clinical Study ◽

Cataract Surgery ◽

Graft Survival ◽

Endothelial Keratoplasty ◽

Descemet’S Membrane Endothelial Keratoplasty ◽

Descemet's Membrane ◽

Comparative Clinical Study ◽

Descemet’S Membrane

Download Full-text

Corneal pachymetry by AS-OCT after Descemet’s membrane endothelial keratoplasty

Scientific Reports ◽

10.1038/s41598-021-93186-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Friso G. Heslinga ◽

Ruben T. Lucassen ◽

Myrthe A. van den Berg ◽

Luuk van der Hoek ◽

Josien P. W. Pluim ◽

...

Keyword(s):

Deep Learning ◽

Endothelial Function ◽

Corneal Thickness ◽

Anterior Segment ◽

Anatomical Landmarks ◽

Endothelial Keratoplasty ◽

Descemet’S Membrane Endothelial Keratoplasty ◽

Descemet's Membrane ◽

Descemet’S Membrane ◽

Thickness Measurements

AbstractCorneal thickness (pachymetry) maps can be used to monitor restoration of corneal endothelial function, for example after Descemet’s membrane endothelial keratoplasty (DMEK). Automated delineation of the corneal interfaces in anterior segment optical coherence tomography (AS-OCT) can be challenging for corneas that are irregularly shaped due to pathology, or as a consequence of surgery, leading to incorrect thickness measurements. In this research, deep learning is used to automatically delineate the corneal interfaces and measure corneal thickness with high accuracy in post-DMEK AS-OCT B-scans. Three different deep learning strategies were developed based on 960 B-scans from 50 patients. On an independent test set of 320 B-scans, corneal thickness could be measured with an error of 13.98 to 15.50 μm for the central 9 mm range, which is less than 3% of the average corneal thickness. The accurate thickness measurements were used to construct detailed pachymetry maps. Moreover, follow-up scans could be registered based on anatomical landmarks to obtain differential pachymetry maps. These maps may enable a more comprehensive understanding of the restoration of the endothelial function after DMEK, where thickness often varies throughout different regions of the cornea, and subsequently contribute to a standardized postoperative regime.

Download Full-text