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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
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...
March 7, 2018: Journal of Cataract and Refractive Surgery
Nir Sorkin, Mahmood Showail, Adi Einan-Lifshitz, Tanguy Boutin, Armand Borovik, Mohammad Kreimei, Amir Rosenblatt, Clara C Chan, David S Rootman
PURPOSE: To analyze the outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with previous Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: This retrospective interventional case series included 26 eyes (26 patients) that underwent DMEK to replace a previous DSAEK graft with at least 6 months of follow-up. The outcome measures were indications for surgery, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, rebubbling rate, rejection, and failure...
March 6, 2018: Cornea
Mohit Parekh, Davide Borroni, Alessandro Ruzza, Hannah J Levis, Stefano Ferrari, Diego Ponzin, Vito Romano
PURPOSE: To compare different Descemet membrane endothelial keratoplasty (DMEK) graft preparation methods. METHODS: Stripping from the trabecular meshwork (M1) using epithelial spatula; stripping by scoring the peripheral endothelium (M2) using Sinskey hook; stripping by punch method (M3) using donor trephine; Submerged hydro-separation (M4); and pneumatic dissection method (M5) were evaluated. Preparation time, costs, endothelial cell loss (ECL) postpreparation, cell death and morphology were compared...
March 9, 2018: Acta Ophthalmologica
Laura Macovei, Ioana Gobej
We report the case of a 69-year-old female with Fuchs endothelial dystrophy and posterior chamber in-the-bag intraocular lens, whom we treated with DMEK surgical technique. We encountered difficulties both during obtaining the endothelium from the young donor and during the intraocular unrolling and its application on the stroma. We evaluated both preoperative and postoperative the following parameters: visual acuity, slit lamp, and optical coherence tomography appearance of the cornea, corneal thickness, intraocular pressure, endothelial cell density...
October 2017: Romanian Journal of Ophthalmology
Fatema Asi, Georgia Milioti, Berthold Seitz
We report a case of corneal decompensation caused by recurrent herpetic endotheliitis that was treated successfully with Descemet membrane endothelial keratoplasty (DMEK). A 62-year-old woman presented with a history of recurrent herpetic infections in the right cornea. After topical and systemic treatment with antivirals and steroids for 5 months, DMEK combined with cataract surgery was performed. Two weeks after DMEK, the corrected distance visual acuity (CDVA) in the affected eye was 0.3 (20/60). One year postoperatively, the CDVA was 1...
January 2018: Journal of Cataract and Refractive Surgery
Mohit Parekh, Alessandro Ruzza, Vito Romano, Elisa Favaro, Mattia Baruzzo, Gianni Salvalaio, Andrea Grassetto, Stefano Ferrari, Diego Ponzin
PURPOSE: To investigate the learning curve of Descemet membrane endothelial keratoplasty (DMEK) graft preparation in an eye bank. METHODS: Four operators prepared 645 DMEK grafts using the stripping technique between 2014 and 2017 at the Veneto Eye Bank Foundation, Italy. Endothelial cell loss (ECL) and tissue wastage were recorded retrospectively after DMEK preparation and correlated with the number of tissues prepared each year by each operator. On average, our operators performed 1 donor preparation a week over the course of this study...
March 1, 2018: Cornea
Oganes G Oganesyan, Vladimir V Neroev, Arthur A Grdikanyan, Vostan R Getadaryan
PURPOSE: To describe the feasibility of same-day, consecutive use of a single donor cornea in 5 patients with corneal pathology, who required anterior lamellar and endothelial keratoplasties. METHODS: Descemet membrane (DM) with endothelium was completely stripped from a single corneoscleral button and punched out from the endothelial side with a circular, standard punch. Using a custom-made punch for linear cutting of DM, we obtained 4 quarter-grafts (Q-graft)...
February 27, 2018: Cornea
Jorge L Alió Del Barrio, Alfredo Vega-Estrada, Jorge L Alió
PURPOSE: To describe an alternative treatment option for secondary Descemet membrane endothelial keratoplasty (DMEK) graft failure, using a second DMEK graft without primary graft removal ("DMEK under DMEK"). METHODS: A 72-year-old patient with pseudophakic bullous keratopathy in the left eye underwent an 8.25-mm second DMEK under an 8.5-mm failed DMEK because of previous graft rejection and subsequent secondary failure. RESULTS: Corrected distance visual acuity improved from 0...
February 22, 2018: Cornea
Adi Einan-Lifshitz, Nir Sorkin, Tanguy Boutin, Zale Mednick, Mohammad Kreimei, Clara C Chan, David S Rootman
PURPOSE: To suggest a new surgical approach for posterior opacities or persistent Descemet membrane (DM) detachment in failed deep anterior lamellar keratoplasty (DALK) and to report the outcome of Descemet membrane endothelial keratoplasty (DMEK) in a series of patients with DALK failure. METHODS: In this retrospective case series of patients who underwent DMEK for failed DALK at Toronto Western Hospital, 4 patients with failed DALK who underwent DMEK surgery were included...
February 22, 2018: Cornea
Miles F Greenwald, Philip I Niles, A Tim Johnson, Jesse M Vislisel, Mark A Greiner
Purpose: To report a case of bilateral iridoschisis with cataracts and corneal decompensation in a patient who underwent cataract extraction and superficial iridectomy followed by Descemet membrane endothelial keratoplasty (DMEK). Observations: A 58-year-old man with previously diagnosed iridoschisis, cataracts, and diabetes mellitus experienced progressive vision loss bilaterally due to corneal decompensation. Slit lamp examination revealed iridoschisis with iris fibrils contacting the corneal endothelium, stromal edema, and mild guttate changes bilaterally...
March 2018: American Journal of Ophthalmology Case Reports
Aline I Riechardt, Julian P Klein, Dino Cordini, Jens Heufelder, Matus Rehak, Ira Seibel, Antonia M Joussen
PURPOSE: This study aims to analyze the effect of salvage proton beam therapy for the treatment of recurrent iris melanoma. METHOD: In this clinical case series, we retrospectively analyzed the data of eight patients who underwent proton beam therapy of the whole anterior segment as salvage therapy between 2000 and 2016 for recurrent iris melanoma after resection, ruthenium brachytherapy, or sector proton beam therapy. Two patients received salvage proton beam therapy for repeated tumor relapse...
February 20, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
E Flockerzi, P Maier, D Böhringer, H Reinshagen, F Kruse, C Cursiefen, T Reinhard, G Geerling, N Torun, B Seitz
PURPOSE: The purpose of this retrospective panel study was to provide an overview of absolute numbers, trends in the types of and indications for corneal transplantation in Germany from 2001 to 2016. METHODS: A questionnaire about absolute numbers, types of transplantation and indications was sent to 111 ophthalmological departments in Germany out of which 94 (85%) provided their data. RESULTS: Since the year 2001, the number of corneal transplantations has increased by 1...
February 1, 2018: American Journal of Ophthalmology
Francisco Arnalich-Montiel, Sara Ortiz-Toquero, Clara Auladell, Ana Couceiro
PURPOSE: To assess intraobserver repeatability, intersession reproducibility, and agreement of swept-source Fourier-domain optical coherence tomography (SS-OCT) and the Scheimpflug camera in measuring corneal thickness in virgin and grafted eyes with Fuchs endothelial corneal dystrophy (FECD). METHODS: Thirty-six control eyes, 35 FECD eyes, 30 FECD with corneal edema eyes, 25 Descemet stripping automated endothelial keratoplasty (DSAEK) eyes, and 29 Descemet membrane endothelial keratoplasty (DMEK) eyes were included...
January 30, 2018: Cornea
Annekatrin Rickmann, Peter Szurman, Sacha Jung, Karl Thomas Boden, Silke Wahl, Arno Haus, Katrin Boden, Kai Januschowski
PURPOSE: To compare the clinical outcomes following Descemet's membrane endothelial keratoplasty (DMEK) with 100% air tamponade versus 10% sulfur hexafluoride (SF 6 ) tamponade. METHODS: Retrospective analysis of 108 consecutive DMEK cases subdivided by anterior chamber tamponade with 54 eyes receiving 10% SF 6 and 54 eyes receiving 100% air injection. A post-hoc matched analysis revealed no statistically significant differences between the groups. The main outcome measurements were the complication rate, including intra- and postoperative complications and graft detachment rate requiring re-bubbling...
January 29, 2018: Current Eye Research
Vasiliki Zygoura, Lamis Baydoun, Lisanne Ham, Vincent J A Bourgonje, Korine van Dijk, Jessica T Lie, Isabel Dapena, Silke Oellerich, Gerrit R J Melles
BACKGROUND/AIM: To assess the clinical outcome of the first series of Quarter-Descemet membrane endothelial keratoplasty (Quarter-DMEK), a potential hybrid technique between 'descemetorhexis only' and conventional, circular DMEK. METHODS: Prospective interventional case series at a tertiary referral centre. Twelve eyes of 12 patients with central Fuchs endothelial corneal dystrophy underwent Quarter-DMEK, that is, transplantation of one quadrant of a full-diameter DMEK graft, and were evaluated for best-corrected visual acuity (BCVA), endothelial cell density (ECD) and complications up to 6 months postoperatively...
January 17, 2018: British Journal of Ophthalmology
Pia Leon, Mohit Parekh, Yoav Nahum, Michael Mimouni, Giuseppe Giannaccare, Laura Sapigni, Alessandro Ruzza, Massimo Busin
PURPOSE: To evaluate the risk factors for early graft detachment in Descemet Membrane Endothelial Keratoplasty (DMEK). DESIGN: Case-control Study. METHODS: ▪ PARTICIPANTS: 173 donor corneas and 173 eyes of the patients following DMEK or DMEK in combination with phacoemulsification and IOL implantation were included. INTERVENTION: Pre-stripped DMEK grafts were transplanted using pull-through technique. At the end of surgery, the anterior chamber was filled with air, which was removed 3 hours later only if pupillary block was suspected...
January 12, 2018: American Journal of Ophthalmology
Albert Y Cheung, Joshua H Hou, Peter Bedard, Veronique Grimes, Natalie Buckman, Medi Eslani, Edward J Holland
PURPOSE: To describe and report outcomes of our single-pass microkeratome technique for preparation of ultrathin (UT, ≤100 μm) and nanothin (NT, ≤50 μm) Descemet stripping automated endothelial keratoplasty (DSAEK) grafts. METHODS: To prepare NT-DSAEK grafts, a pachymetry nomogram specific to each technician and individual microkeratome head was developed based on accumulated precut and postcut pachymetry data from previous DSAEK grafts. Mean graft thickness as well as precut and postcut endothelial cell counts (ECCs) of NT-DSAEK, UT-DSAEK, and Descemet membrane endothelial keratoplasty (DMEK) grafts between July 2015 and July 2017 were calculated and compared statistically...
January 11, 2018: Cornea
Javier Cabrerizo, Thomas Forshaw, Clara Rodriguez-Aierbe, Jesus Garrido-Fierro
We set out to determine microscopic characteristics of the Descemet membrane interface during Descemet membrane endothelial keratoplasty (DMEK) graft preparation. Ten corneas were partially prepared, preserving half of the Descemet membrane attached to the stroma to enable visualisation of the Descemet-stroma interface. This tissue was prepared for viewing with a scanning electron microscope. The Descemet-stroma interface was categorised into three regions: centre, mid-periphery and periphery. We classified adhesions in these regions as either minor thread-like adhesions or major bridge-like adhesions with stromal detachments...
January 11, 2018: Scientific Reports
Christopher S Sáles, Michael D Straiko, Ana Alzaga Fernandez, Kelly Odell, Philip K Dye, Khoa D Tran
PURPOSE: To present a novel apparatus for simulating the anterior and posterior segment pressure dynamics involved in executing Descemet membrane endothelial keratoplasty (DMEK) surgery when using a chamber-shallowing technique. METHODS: An artificial anterior chamber (AAC), 18-mm trephine, latex glove, two 3-mL syringes, and one donor cornea comprising an intact corneoscleral cap from which a DMEK tissue was peeled and punched are required for the model. After making the corneal incisions with the corneoscleral cap mounted on the AAC in the usual fashion, the corneoscleral cap is remounted onto the dried AAC over an 18-mm latex diaphragm...
February 2018: Cornea
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