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https://www.readbyqxmd.com/read/27918355/experienced-dsaek-surgeon-s-transition-to-dmek-outcomes-comparing-the-last-100-dsaek-surgeries-with-the-first-100-dmek-surgeries-exclusively-using-previously-published-techniques
#1
Paul M Phillips, Louis J Phillips, Valliamai Muthappan, Charlene M Maloney, Christopher N Carver
PURPOSE: To compare outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) when an experienced DSAEK surgeon transitions to DMEK while following 2 published endothelial keratoplasty surgical techniques. METHODS: This is a retrospective review of 200 eyes of 132 patients with Fuchs corneal dystrophy that underwent endothelial keratoplasty performed by one surgeon. Published, standardized techniques were followed for both DSAEK and DMEK...
December 1, 2016: Cornea
https://www.readbyqxmd.com/read/27906816/intraocular-pressure-measurements-after-descemet-membrane-endothelial-keratoplasty
#2
Anna-Karina B Maier, Enken Gundlach, Milena Pahlitzsch, Johannes Gonnermann, Caitlin Corkhill, Eckart Bertelmann, Antonia M Joussen, Matthias K J Klamann, Necip Torun
PURPOSE: Intraocular pressure (IOP) elevation occurs regularly after Descemet membrane endothelial keratoplasty (DMEK). This study evaluated the effect of central corneal thickness (CCT) on the IOP after DMEK. PATIENTS AND METHODS: This prospective study recorded the IOP of 46 eyes from 46 patients preoperatively, and then 1 and 3 months after DMEK. IOP measurement was performed by noncontact pneumatic tonometry (NCT), iCare, Goldmann applanation tonometry (GAT), and dynamic contour tonometry (DCT)...
November 30, 2016: Journal of Glaucoma
https://www.readbyqxmd.com/read/27893525/outcomes-of-descemet-membrane-endothelial-keratoplasty-in-patients-with-previous-glaucoma-surgery
#3
Carolina Aravena, Fei Yu, Sophie X Deng
PURPOSE: To evaluate outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with previous trabeculectomy or a drainage device. METHODS: This is a retrospective study of 108 consecutive DMEK performed between October 2013 and December 2015. All eyes were divided into 3 groups: surgical treatment (ST) group, medical treatment (MT) group, and control group. Visual improvement, endothelial cell loss, and postoperative complications, including rejection, graft failure, and intraocular pressure elevation (≥25 mm Hg) were evaluated...
November 23, 2016: Cornea
https://www.readbyqxmd.com/read/27873063/-a%C3%A2-new-technique-to-facilitate-donor-preparation-for-dmek-surgery
#4
P W Rieck, T Engels
BACKGROUND: Descemet membrane endothelial keratoplasty (DMEK) is becoming more and more the method of choice to treat corneal endothelial diseases in specialized centers. The reasons that prevent this technique from becoming widespread are the delicate donor tissue preparation. By inverting the curvature of the cornea from convex to concave after mounting onto an artificial anterior chamber, we developed a combined manual delamination and hydrodissection technique, which allows a rapid and endothelium-preserving method of separating donor Descemet membranes from the underlying stroma...
November 21, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/27873061/-opacification-of-a-hydrophilic-acrylic-intraocular-lens-after-dmek-a-material-analysis
#5
C Milojcic, C Latz, T Tandogan, G U Auffarth, F G Holz, C Y Choi, R Khoramnia
OBJECTIVE: Calcification of a hydrophilic intraocular lens (IOL) is a rare complication. We report on the analysis of an opacified IOL, which was explanted 2 years after Descemet membrane endothelial keratoplasty (DMEK), using light and scanning electron microscopy, X‑ray spectroscopy and investigations on the optical bench. METHODS: In October 2012 a patient with pseudophakic keratopathy and Fuchs endothelial dystrophy underwent DMEK with double rebubbling. Due to primary graft failure the patient underwent penetrating keratoplasty in January 2013...
November 21, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/27861306/enhancing-dmek-success-by-identifying-optimal-levels-of-trypan-blue-dye-application-to-donor-corneal-tissue
#6
Parag A Majmudar, Lauren Johnson
PURPOSE: The purpose of this study was to determine the correct concentration and duration of application of trypan blue dye to Descemet membrane endothelial keratoplasty (DMEK) donor corneal tissue before transplant to enhance visibility while minimizing damage to the tissue. METHODS: Corneas were precut for DMEK using an 8-mm punch, and each was stained with either 0.06% or 0.15% trypan blue for a duration of 1, 3, or 5 minutes. After staining, each tissue was placed in balanced salt solution and observed to determine how quickly the stain faded from the tissue using a grading system...
November 16, 2016: Cornea
https://www.readbyqxmd.com/read/27836829/one-year-outcome-after-descemet-membrane-endothelial-keratoplasty-dmek-comparing-sulfur-hexafluoride-sf6-20-versus-100-air-for-anterior-chamber-tamponade
#7
Friederike Schaub, Philip Enders, Katharina Snijders, Silvia Schrittenlocher, Sebastian Siebelmann, Ludwig M Heindl, Björn O Bachmann, Claus Cursiefen
PURPOSE: To investigate 1-year clinical outcome and complication rates following Descemet membrane endothelial keratoplasty (DMEK) with sulfur hexafluoride 20% (SF620%) anterior chamber tamponade compared with conventionally used 100% air for primary graft attachment during DMEK surgery. METHODS: Records of 1112 consecutive DMEKs were reviewed retrospectively and grouped by anterior chamber tamponade used during DMEK surgery (SF620% vs 100% air). Outcome measures included intraocular pressure (IOP), best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD) and central corneal thickness (CCT) at 1, 3, 6 and 12 months after DMEK surgery...
November 11, 2016: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27811568/enhancing-descemet-membrane-endothelial-keratoplasty-in-postvitrectomy-eyes-with-the-use-of-pars-plana-infusion
#8
Nir Sorkin, Adi Einan-Lifshitz, Zach Ashkenazy, Tanguy Boutin, Mahmood Showail, Armand Borovik, Murad Alobthani, Clara C Chan, David S Rootman
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...
November 2, 2016: Cornea
https://www.readbyqxmd.com/read/27811564/impact-of-surgical-learning-curve-in-descemet-membrane-endothelial-keratoplasty-on-visual-acuity-gain
#9
Guillaume Debellemanière, Emmanuel Guilbert, Romain Courtin, Christophe Panthier, Patrick Sabatier, Damien Gatinel, Alain Saad
PURPOSE: To evaluate the learning curve for graft preparation and graft unrolling during Descemet membrane endothelial keratoplasty (DMEK) and to assess the evolution of visual acuity gain and percentage cell loss with experience. METHODS: The first 109 DMEK procedures performed by a single surgeon (A.S.) at the Rothschild Foundation Ophthalmology Hospital in Paris, France, between March 2012 and November 2014 were included. Best-corrected visual acuity and endothelial cell density were recorded preoperatively and again 1 week, 1 month, 3 months, and 6 months after DMEK...
January 2017: Cornea
https://www.readbyqxmd.com/read/27780445/a-comprehensive-review-of-postoperative-management-of-descemet-s-membrane-endothelial-keratoplasty
#10
Yuna Rapoport, Peter Veldman
INTRODUCTION: As Descemet's Membrane Endothelial Keratoplasty (DMEK) continues to gain in popularity, the postoperative management of DMEK surgery is becoming increasingly important, as these management strategies may affect postoperative success rates. MATERIALS AND METHODS: This article reviews the current evidence for postoperative management in DMEK. RESULTS: There are variable strategies in the postoperative management of DMEK as it relates to postoperative positioning, need for and timing of rebubble, tamponade agent utilized (both primarily and at rebubble), steroid agent and tapering schedule, timing of secondary regraft when required, and postoperative monitoring...
October 26, 2016: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/27777123/descemet-membrane-adhesion-strength-is-greater-in-diabetics-with-advanced-disease-compared-to-healthy-donor-corneas
#11
Chaid Schwarz, Benjamin T Aldrich, Kimberlee A Burckart, Gregory A Schmidt, M Bridget Zimmerman, Cynthia R Reed, Mark A Greiner, Edward A Sander
Descemet membrane endothelial keratoplasty (DMEK) is an increasingly popular surgical procedure for treating ocular diseases that require a corneal transplant. Previous studies have found that tissue tearing during surgical preparation is more likely elevated in eyes from donors with a history of diabetes mellitus. To quantify these potential differences, we established an experimental technique for quantifying the force required to separate the endothelium-Descemet membrane complex (EDM) from stroma in human donor corneal tissue, and we assessed differences in adhesion strength between diabetic and non-diabetic donor corneas...
October 21, 2016: Experimental Eye Research
https://www.readbyqxmd.com/read/27755190/role-of-initial-intraocular-pressure-in-graft-adhesion-after-descemet-membrane-endothelial-keratoplasty
#12
Nikola Schmeckenbächer, Andreas Frings, Friedrich E Kruse, Theofilos Tourtas
PURPOSE: To analyze the role of initial intraoperative intraocular pressure (IOP) in graft adhesion in Descemet membrane endothelial keratoplasty (DMEK) during early follow-up. METHODS: This retrospective, observational, single-center case series included 118 eyes from 118 consecutive patients treated between May and July 2015 for DMEK or combined DMEK and phacoemulsification (triple-DMEK). Exclusion criteria were previous eye surgery other than cataract surgery, loss of follow-up, any application of IOP-lowering medication before and after surgery, and low intraindividual repeatability of IOP measurements...
January 2017: Cornea
https://www.readbyqxmd.com/read/27741015/donor-endothelial-cell-density-measurements-do-not-change-immediately-after-dmek-preparation
#13
Zachary M Mayko, Beth Ann Benetz, Harry Menegay, Christopher P Donovan, Christopher G Stoeger, Mark A Terry, Jonathan H Lass
PURPOSE: To evaluate a single eye bank's measurement of endothelial cell density (ECD) of Descemet membrane endothelial keratoplasty (DMEK) grafts before and after preparation using 2 separate counting methods. METHODS: A series of 60 donor tissues were prepared for DMEK surgery. One to 4 specular images of the central endothelium were taken both before and after preparation, and ECDs were evaluated for a total of 345 unique images. Images were then masked and provided to the Cornea Image Analysis Reading Center (CIARC) for independent analysis...
October 12, 2016: Cornea
https://www.readbyqxmd.com/read/27718006/graft-dislocation-and-graft-failure-following-descemet-membrane-endothelial-keratoplasty-dmek-using-precut-tissue-a-retrospective-cohort-study
#14
Sonja Heinzelmann, Daniel Böhringer, Philipp Eberwein, Thomas Reinhard, Philip Maier
PURPOSE: Although the functional results following DMEK are better than after DSAEK, DSAEK still seems to be the standard procedure, as surgeons fear losing grafts during DMEK graft preparation. Therefore, eye banks offer precut DMEK grafts for direct use by the surgeon. Here, we analysed the functional results and complication rates for a precut technique compared to fresh preparations. METHODS: We retrospectively compared 453 standard to 11 precut (1-2 days before surgery) DMEK cases...
October 8, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/27665214/histopathologic-features-of-descemet-membrane-endothelial-keratoplasty-graft-remnants-folds-and-detachments
#15
Thomas M Müller, Robert M Verdijk, Itay Lavy, Marieke Bruinsma, Jack Parker, Perry S Binder, Gerrit R J Melles
PURPOSE: To describe the histologic features of postmortem eyes after Descemet membrane endothelial keratoplasty (DMEK) and their potential clinical implications. DESIGN: Histopathologic study. PARTICIPANTS: Eleven postmortem DMEK corneas of 8 patients who underwent surgery for Fuchs endothelial dystrophy, with an average postoperative time of 4±1.9 years (range, 7 months-6.5 years). METHODS: Eleven corneas transplanted with a DMEK graft were procured after death and processed for light microscopy evaluation...
December 2016: Ophthalmology
https://www.readbyqxmd.com/read/27661069/two-year-refractive-outcomes-after-descemet-membrane-endothelial-keratoplasty
#16
Korine van Dijk, Marina Rodriguez-Calvo-de-Mora, Hilde van Esch, Laurence Frank, Isabel Dapena, Lamis Baydoun, Silke Oellerich, Gerrit R J Melles
PURPOSE: To monitor refractive changes after Descemet membrane endothelial keratoplasty (DMEK) and to determine what may influence these changes and the time point of stabilization. METHODS: From 67 pseudophakic DMEK eyes operated on for Fuchs endothelial dystrophy at a tertiary referral center, biomicroscopy, visual acuity, subjective refraction, and Scheimpflug-based corneal tomography data were obtained before and up to 2 years postoperatively. Visual acuity and changes in spherical equivalent (SE), mean anterior and posterior simulated keratometry (Km), and central pachymetry were analyzed...
September 21, 2016: Cornea
https://www.readbyqxmd.com/read/27617872/sex-chromosome-analysis-of-postmortem-corneal-endothelium-after-sex-mismatch-descemet-membrane-endothelial-keratoplasty
#17
Itay Lavy, Robert M Verdijk, Marieke Bruinsma, Hein F Sleddens, Silke Oellerich, Perry S Binder, Gerrit R J Melles
PURPOSE: To identify the origin of corneal endothelial cells (host or donor) present on grafts at various time points after Descemet membrane endothelial keratoplasty (DMEK), using fluorescence in situ hybridization (FISH) of sex chromosomes on post mortem corneas with sex mismatch between the donor and host. METHODS: Corneoscleral buttons of 6 post mortem DMEK eyes of 4 patients, operated for Fuchs endothelial dystrophy, with an average postoperative time of 2...
January 2017: Cornea
https://www.readbyqxmd.com/read/27609713/splitting-of-the-recipient-s-descemet-s-membrane-in-descemet-membrane-endothelial-keratoplasty-ultrastructure-and-clinical-relevance
#18
Julia M Weller, Ursula Schlötzer-Schrehardt, Friedrich E Kruse, Theofilos Tourtas
PURPOSE: In Descemet membrane endothelial keratoplasty (DMEK), lamellar splitting of the Descemet's membrane (DM) may occur during stripping of host's DM, leaving residual DM on the recipient's DMEK interface. The purpose of this study was to determine the incidence rate of lamellar splitting of DM during DMEK and to describe the ultrastructure of DM in these eyes. DESIGN: Retrospective consecutive case series METHODS: Setting: Institutional, single-center PATIENT POPULATION: 664 eyes with Fuchs endothelial corneal dystrophy (FECD) scheduled for primary DMEK...
September 5, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27609712/mid-term-results-of-descemet-membrane-endothelial-keratoplasty-dmek-4-to-7-years-clinical-outcome
#19
Lisanne Ham, Isabel Dapena, Vasilis S Liarakos, Lamis Baydoun, Korine van Dijk, Abbas Ilyas, Silke Oellerich, Gerrit R J Melles
PURPOSE: To evaluate the mid-term outcomes of Descemet membrane endothelial keratoplasty (DMEK) up to 4-7 years postoperatively. DESIGN: Retrospective, consecutive interventional case series. METHODS: A total of 250 consecutive eyes of 209 patients who underwent DMEK at our institute and had potentially at least 4 years of follow-up. Main outcome measures were best corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), graft survival rate and postoperative complications...
September 5, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27607149/descemet-membrane-endothelial-keratoplasty-for-epithelial-downgrowth-after-clear-corneal-cataract-surgery
#20
Young Shin Kim, So-Young Jin, Jin Kwon Chung
OBJECTIVES: To describe the first case of Descemet membrane endothelial keratoplasty (DMEK) combined with argon laser photocoagulation and intracameral 5-fluorouracil (5-FU) injection in a patient with epithelial downgrowth after cataract surgery. METHODS: Case report and review of the literature. RESULTS: A 77-year-old female underwent uneventful cataract surgery using a clear corneal incision in her left eye. Six months after surgery, an epithelial cell sheet began to cover the posterior cornea and then spread to the anterior chamber structures, leading to anterior synechia and corectopia at 2 years...
September 7, 2016: Eye & Contact Lens
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