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https://www.readbyqxmd.com/read/29781929/femtosecond-laser-assisted-graft-preparation-for-descemet-membrane-endothelial-keratoplasty
#1
Hamish D McKee, Vishal Jhanji
PURPOSE: To describe a technique of using a femtosecond laser to assist with graft preparation for Descemet membrane endothelial keratoplasty (DMEK). METHODS: A femtosecond laser was used to assist in graft preparation for 3 DMEK procedures. The donor cornea is mounted on a proprietary artificial anterior chamber. A partial thickness deep circular cut is made with the femtosecond laser through the endothelium, Descemet membrane, and posterior stroma. Graft preparation is then completed without the use of a corneal trephine...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29756410/the-feasibility-and-efficacy-of-preparing-porcine-descemet-s-membrane-endothelial-keratoplasty-dmek-grafts-by-two-techniques-an-ex-vivo-investigation-for-future-xeno-dmek
#2
Yang Liu, Jing Zhang, Yingnan Zhang, Mingyang Yin, Sen Miao, Qingfeng Liang, Zhiqiang Pan
BACKGROUND: Descemet's membrane endothelial keratoplasty (DMEK) might be a promising technique for future xeno-corneal transplantation due to its ultrathin graft, extremely low rejection occurrence, suture-free graft fixation, and minimal immunosuppressive regime usage. The aim of this study is to explore the feasibility and efficacy of preparing porcine DMEK grafts by 2 techniques and investigate the graft ultrastructure. METHODS: Two mainstream techniques, mechanical stripping technique and liquid bubble technique, were modified to prepare the porcine DMEK grafts...
May 13, 2018: Xenotransplantation
https://www.readbyqxmd.com/read/29755822/descemet-membrane-endothelial-keratoplasty-with-irregular-edged-graft-a-salvage-method-for-large-radial-graft-tears
#3
Mehmet Cüneyt Özmen, Nilay Dilekmen, Erdem Yüksel, Bahri Aydın, Fikret Akata
Large radial tears of donor Descemet membrane (DM) during the preparation of Descemet membrane endothelial keratoplasty (DMEK) grafts can make the trephination stage impossible because of small graft diameter. This results in irregular-edged grafts. In this study, we report two pseudophakic bullous keratopathy patients who underwent DMEK surgery with irregular-edged Descemet membrane (DM) grafts. Main outcome measures were preoperative and postoperative 1-, 3-, and 6-month best corrected visual acuity (BCVA), endothelial cell density (ECD) and central corneal thickness (CCT)...
April 2018: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/29746329/descemet-membrane-endothelial-keratoplasty-after-penetrating-keratoplasty-features-for-success
#4
Adi Einan-Lifshitz, Avner Belkin, Nir Sorkin, Zale Mednick, Tanguy Boutin, Ishrat Gill, Mohammad Karimi, Clara C Chan, David S Rootman
PURPOSE: To evaluate Descemet membrane endothelial keratoplasty (DMEK) in the setting of failed penetrating keratoplasty (PKP) and to identify factors associated with DMEK success and failure after PKP. METHODS: A retrospective chart review of patients who underwent DMEK for failed PKP at Toronto Western Hospital, Canada, between 2014 and 2017 was performed. Demographic characteristics, number of previous transplants, intraoperative and postoperative complications, best spectacle-corrected visual acuity (BSCVA), and endothelial cell density were analyzed...
May 8, 2018: Cornea
https://www.readbyqxmd.com/read/29737973/in-vivo-endothelial-cell-density-decline-in-the-early-postoperative-phase-after-descemet-membrane-endothelial-keratoplasty
#5
Alina Miron, Marieke Bruinsma, Lisanne Ham, Sontje-Chiao Schaal, Lamis Baydoun, Isabel Dapena, Silke Oellerich, Gerrit R J Melles
PURPOSE: To evaluate endothelial cell density (ECD) in the first 6 months after Descemet membrane endothelial keratoplasty (DMEK) by eliminating method error as a confounding variable. METHODS: From 24 DMEK eyes operated for Fuchs endothelial corneal dystrophy, from which specular microscopy images could be taken at 1 day and 6 months postoperatively, ECD values were compared between these 2 time points. RESULTS: Using the 1-day ECD measurement as baseline, mean ECD decreased from 1913 (±326) cells/mm to 1524 (±393) cells/mm at 6 months, a decline of -18 (±19)%...
June 2018: Cornea
https://www.readbyqxmd.com/read/29731147/five-year-graft-survival-of-descemet-membrane-endothelial-keratoplasty-ek-versus-descemet-stripping-ek-and-the-effect-of-donor-sex-matching
#6
David A Price, Meagan Kelley, Francis W Price, Marianne O Price
PURPOSE: To determine whether the reduced risk of immunologic rejection with Descemet membrane endothelial keratoplasty (DMEK) results in a 5-year survival advantage relative to Descemet stripping endothelial keratoplasty (DSEK) and to determine whether matching the donor and recipient sex affects the rejection episode and graft survival rates. DESIGN: Retrospective cohort study. PARTICIPANTS: Patients with Fuchs' endothelial corneal dystrophy treated with DSEK or DMEK...
May 3, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29673628/-descemet-s-membrane-endothelial-keratoplasty-indication-surgical-technic-postoperative-management-and-review-of-literature
#7
REVIEW
V Kocaba, O Damour, C Auxenfans, C Burillon
Endothelial keratoplasty is currently the preferred method for the treatment of endothelial dysfunctions and dystrophies. Descemet Membrane Endothelial Keratoplasty (DMEK), described by Gerrit Melles in 2006, is performed by selectively replacing the damaged endothelium with a healthy counterpart. It leads to a faster visual recovery and better refractive outcomes with a limited risk of rejection compared to Descemet's Stripping Automated Endothelial Keratosplasty (DSAEK), which includes a thin stromal layer...
April 17, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29672430/recovery-of-corneal-clarity-after-dmek-followed-by-rebubbling-versus-uneventful-dmek
#8
Apostolos Lazaridis, Ourania Fydanaki, Eleftherios Giallouros, Ilias Georgalas, George Kymionis, Walter Sekundo, Konstantinos Droutsas
PURPOSE: To evaluate the effect of a single rebubbling procedure after Descemet membrane endothelial keratoplasty (DMEK) on corneal backscatter and endothelial cell loss (ECL). METHODS: Medical records of 130 consecutive DMEK cases (118 patients) were reviewed and 3 groups were formed: group 1 (n = 32), consisting of DMEK cases followed by 1 rebubbling; group 2a (n = 55), including uneventful DMEK cases with complete graft attachment; and group 2b (n = 25), including uneventful DMEK cases with minor peripheral detachment, not requiring rebubbling...
April 19, 2018: Cornea
https://www.readbyqxmd.com/read/29668572/atypical-presentation-of-iridocorneal-endothelial-syndrome-with-band-keratopathy-but-no-corneal-edema-managed-with-descemet-membrane-endothelial-keratoplasty
#9
Vasiliki Zygoura, Itay Lavy, Robert M Verdijk, Diana Santander-García, Lamis Baydoun, Isabel Dapena, Gerrit R J Melles
PURPOSE: To report an unusual presentation of iridocorneal endothelial (ICE) syndrome associated with band keratopathy and its management with ethylenediamine-tetraacetic acid (EDTA) chelation and Descemet membrane endothelial keratoplasty (DMEK). METHODS: A 57-year-old female patient presented with unilateral progressive painless visual impairment, corneal band keratopathy, and morphological corneal endothelial changes without corneal edema or any previous ophthalmic, medical, or family history...
April 17, 2018: Cornea
https://www.readbyqxmd.com/read/29661044/dmek-versus-dsaek-for-fuchs-endothelial-dystrophy-a-meta-analysis
#10
Raquel Esteves Marques, Paulo Silva Guerra, David Cordeiro Sousa, Ana Inês Gonçalves, Ana Miguel Quintas, Walter Rodrigues
PURPOSE: To compare the safety and efficacy profiles of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in adult patients with Fuchs' endothelial dystrophy. METHODS: Electronic database search on MEDLINE and CENTRAL from inception to August 2017. We included all comparative studies of DMEK versus DSAEK in patients with diagnosed Fuchs' endothelial dystrophy. Studies assessing rescue procedures were excluded to minimize bias...
April 1, 2018: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/29624509/graft-detachment-pattern-after-descemet-membrane-endothelial-keratoplasty-comparing-air-versus-20-sf6-tamponade
#11
Sebastian Siebelmann, Sebastian Lopez Ramos, Paula Scholz, Mario Matthaei, Silvia Schrittenlocher, Ludwig M Heindl, Björn Bachmann, Claus Cursiefen
PURPOSE: The change from air to 20% sulfur hexafluoride (SF6) as anterior chamber tamponade for Descemet membrane endothelial keratoplasty (DMEK) significantly reduced the rebubbling rate. Nonetheless, underlying mechanisms are not completely understood. In this study, we investigate the morphology of graft detachments after DMEK depending on the tamponade and its influence on postoperative rebubbling. METHODS: In this retrospective analysis of prospective data of 204 consecutive patients who underwent DMEK with 100% air, or 20% SF6, we compared the SF6 group with the air group regarding the number, lateral and axial diameter and localization of detachments, visual acuity (BSCVA), and incidence of rebubbling after 1 week (T1), after 1 (T2), 3 (T3), 6 (T4), and 12 (T5) months postoperatively...
April 5, 2018: Cornea
https://www.readbyqxmd.com/read/29624508/viscoleastic-tamponade-applied-to-the-ocular-surface-for-enhanced-control-of-gaseous-egress-from-the-anterior-chamber-during-final-bubble-titration-in-dmek-surgery-the-polite-burp
#12
Christopher S Sales, Ana Alzaga Fernandez, Zane Anwar
PURPOSE: To present a novel technique for enhancing the surgeon's control over the volume of air or gas that is "burped" from the anterior chamber during final bubble and intraocular pressure (IOP) titration in Descemet membrane endothelial keratoplasty. METHODS: After ascertaining that the intracameral bubble is either too large and/or has rendered IOP too high, a bead of ophthalmic viscoelastic is applied to the ocular surface over a paracentesis incision, which is then depressed in the usual fashion to burp gas from the anterior chamber...
April 5, 2018: Cornea
https://www.readbyqxmd.com/read/29621512/evolution-of-outcomes-of-consecutive-dmek-surgeries-throughout-a-5-year-period-at-a-single-center-performed-by-two-experienced-dmek-surgeons
#13
Silvia Schrittenlocher, Friederike Schaub, Deniz Hos, Sebastian Siebelmann, Claus Cursiefen, Björn Bachmann
PURPOSE: To assess the evolution of clinical outcomes of more than 1300 DMEKs alone or in combination with cataract surgery (triple-DMEK) throughout a 5-year period at a single center performed by two already experienced DMEK surgeons. DESIGN: Retrospective trend study. METHODS: Review of charts between July 2011 and July 2016 at the Department of Ophthalmology, University of Cologne, Germany. RESULTS: 1340 out of 1340 eyes with sufficient information were included...
April 2, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29619650/endothelial-keratoplasty-in-eyes-with-a-retained-angle-supported-intraocular-lens
#14
Konstantinos Droutsas, Apostolos Lazaridis, George Kymionis, Klio Chatzistefanou, Dimitris Papaconstantinou, Walter Sekundo, Chryssanthi Koutsandrea
PURPOSE: To describe the outcomes of endothelial keratoplasty (EK) for bullous keratopathy in eyes with a retained angle-supported anterior chamber intraocular lens (acIOL). METHODS: Among 263 consecutive EK procedures, 7 DMEK and 11 DSAEK procedures were identified in eyes with an acIOL and included in the present retrospective case series. Pre- and postoperative status including ocular history, anatomical outcome and complications as well as best-corrected visual acuity was evaluated...
April 4, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29595764/use-of-donor-corneas-from-pseudophakic-eyes-for-descemet-membrane-endothelial-keratoplasty
#15
Thabo Lapp, Sonja Heinzelmann, Daniel Böhringer, Philipp Eberwein, Thomas Reinhard, Philip Maier
PURPOSE: The prevalence of pseudophakia increases with age and affects more than 30% of people older than 80 years. Because grafts from older donors seem to be more suitable for Descemet membrane endothelial keratoplasty (DMEK) surgery rather than grafts from younger donors, eye bank technicians and corneal surgeons have to deal with corneas from pseudophakic donors for DMEK graft preparation. However, graft preparation from corneas of pseudophakic donors can be more complicated. METHODS: We retrospectively analyzed our donor registry for the prevalence of pseudophakia...
March 27, 2018: Cornea
https://www.readbyqxmd.com/read/29595762/transplantation-blues-inadvertent-staining-of-amyloid-deposits-with-trypan-blue
#16
Agathe Marcon, Nicolas Périllat, Thibaud Garcin, Rémy Jullienne, Zhiguo He, Fabien Forest, Anne Sophie Gauthier, Philippe Gain, Gilles Thuret
PURPOSE: To describe inadvertent persistent staining of stromal amyloid deposits by trypan blue (TB) after penetrating keratoplasty (PK) and Descemet membrane endothelial keratoplasty (DMEK) performed in patients with corneal amyloidosis. METHODS: Case series of patients with corneal amyloidosis in whom intraoperative TB was used. RESULTS: One patient, hospitalized for acute rejection 6 weeks after DMEK, presented with an intense blue staining of small, spindle-shaped structures in the anterior half of the cornea...
March 27, 2018: Cornea
https://www.readbyqxmd.com/read/29561350/sulfur-hexafluoride-20-versus-air-100-for-anterior-chamber-tamponade-in-dmek-a-meta-analysis
#17
Raquel Esteves Marques, Paulo Silva Guerra, David Cordeiro Sousa, Nuno Pinto Ferreira, Ana Inês Gonçalves, Ana Miguel Quintas, Walter Rodrigues
PURPOSE: To compare intracameral 20% sulfur hexafluoride (SF6) versus 100% air as tamponade for graft attachment in Descemet membrane endothelial keratoplasty (DMEK). METHODS: Using an electronic database search on MEDLINE and CENTRAL from inception to December 2017, we performed a literature review and meta-analysis including all comparative studies of SF6 at a 20% concentration (20% SF6) versus pure air (100% air) for anterior chamber tamponade in DMEK. The primary outcome was the rebubbling rate at the final observation...
June 2018: Cornea
https://www.readbyqxmd.com/read/29557816/outcomes-of-hemi-descemet-membrane-endothelial-keratoplasty-for-fuchs-endothelial-corneal-dystrophy
#18
Rénuka S Birbal, Shugi Hsien, Vasiliki Zygoura, Jack S Parker, Lisanne Ham, Korine van Dijk, Isabel Dapena, Lamis Baydoun, Gerrit R J Melles
PURPOSE: To report the mid-term outcomes of hemi-Descemet membrane endothelial keratoplasty (hemi-DMEK) performed for Fuchs endothelial corneal dystrophy (FECD). METHODS: In this prospective, interventional case series, we evaluated clinical outcomes of 10 eyes from 10 patients who underwent hemi-DMEK for FECD. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), central pachymetry, and postoperative complications. RESULTS: At 1 year postoperatively, 7/7 eyes (excluding 2 eyes with low visual potential) reached a BCVA of ≥20/40 (≥0...
March 19, 2018: Cornea
https://www.readbyqxmd.com/read/29547408/quantitative-assessment-of-aqueous-flare-after-descemet-membrane-endothelial-keratoplasty-for-fuchs-endothelial-dystrophy
#19
Lamis Baydoun, Fook Chang Lam, Sontje Schaal, Shugi Hsien, Silke Oellerich, Korine van Dijk, Gerrit R J Melles
PURPOSE: To assess aqueous flare as a measure of subclinical inflammation after Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy. METHODS: In this prospective cross-sectional and longitudinal case series at a tertiary referral center, 173 DMEK eyes of 169 patients and 19 age-matched healthy control eyes were included. Aqueous flare [photon count per millisecond (ph/ms)] was assessed by laser flare photometry at 1 day, 1 week, and 1 month after DMEK in group I (evaluation of postsurgical blood-aqueous barrier recovery; n = 25) and on average 28 (±19) months (range, 3-86 months) after DMEK in group II (evaluation of long-term inflammation; n = 148)...
March 15, 2018: Cornea
https://www.readbyqxmd.com/read/29525615/intraoperative-hyphema-in-descemet-membrane-endothelial-keratoplasty-alone-or-combined-with-phacoemulsification
#20
Jonathan W Crews, Marianne O Price, Jeferson Lautert, Matthew T Feng, Francis W Price
PURPOSE: To identify whether intraoperative hyphema from the peripheral iridotomy during Descemet membrane endothelial keratoplasty (DMEK) is associated with anticoagulant or antiplatelet use, age, combined phacoemulsification, or adverse outcomes. SETTING: Price Vision Group, Indianapolis, Indiana, USA. DESIGN: Retrospective case series. METHODS: Data were obtained from consecutive DMEK cases with an intraoperative iridotomy from July 2015 through July 2016...
February 2018: Journal of Cataract and Refractive Surgery
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