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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
Yogesh Bhadange, Jeferson Lautert, Shimin Li, Edward Lawando, Edward T Kim, Mark C Soper, Francis W Price, Marianne O Price, Joseph A Bonanno
PURPOSE: To determine whether hypoxia preconditioning can protect corneal endothelial cells from mechanical stress and perioperative procedures mimicking Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Preconditioning was delivered by 2 hours of 0.5% oxygen incubation in a hypoxia chamber or by exposure to the prolyl hydroxylase inhibitor FG-4592, which prevents hypoxia-inducible factor-1 alpha degradation. Damage to whole corneas was produced by brief sonication...
April 2018: Cornea
Itaru Oyakawa, Takahiko Hayashi, Toshiki Shimizu, Naoko Kato
Purpose: Descemet's stripping automated endothelial keratoplasty (DSAEK) is more difficult in hypotonic eyes with filtering bleb, due to the difficulties in elevating the intraocular pressure (IOP). We report a new method that uses ophthalmic viscoelastic devices (OVDs) to achieve good graft adhesion. Case Presentation: We performed modified DSAEK surgery on 2 eyes of 2 patients, who had previously undergone a trabeculectomy. Both eyes had functioning filtering blebs; the IOP was lower than 10 mmHg without medication...
2018: Case Reports in Ophthalmological Medicine
Abdulrahman Khairallah
BACKGROUND: Failed corneal graft management is a challenge. Descemet stripping automated endothe.lial keratoplasty (DSAEK) and repeat penetrating keratoplasty (PKP) are two options. Only two studies have compared outcomes of DSAEK and PKP in the management of a failed graft. OBJECTIVE: To compare the visual outcomes, changes in intraocular pressure (IOP) and complications in eyes with failed corneal grafts that were subsequently managed with DSAEK and PKP. DESIGN: Retrospective cohort study...
January 2018: Annals of Saudi Medicine
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
Mohammad Ali Javadi, Sepehr Feizi, Roya Jafari, Seyed Bagher Hosseini, Sharareh Safapour
Purpose: To determine the factors that influence the endothelial cell density (ECD) of donor grafts after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: This retrospective, interventional case series comprised 77 eyes of 64 patients who underwent DSAEK. Confocal microscopy was performed at the final follow-up examination to evaluate the endothelial cell count, cell morphology, and graft thickness. Univariate and multiple linear regression analyses were used to investigate recipient-, donor-, surgical-, and postoperative related variables capable of influencing graft endothelial cell counts after DSAEK...
January 2018: Journal of Ophthalmic & Vision Research
Hiroyuki Yazu, Takefumi Yamaguchi, Naohiko Aketa, Kazunari Higa, Terumasa Suzuki, Yukari Yagi-Yaguchi, Yoshiyuki Satake, Takayuki Abe, Kazuo Tsubota, Jun Shimazaki
Purpose: To evaluate the association between endothelial cell density (ECD) after Descemet's stripping automated endothelial keratoplasty (DSAEK) and preoperative cytokine levels in the aqueous humor (AqH). Methods: This prospective consecutive case series included 97 consecutive patients who underwent DSAEK (64 eyes) or cataract surgery (33 eyes). AqH samples were collected at the beginning of each surgery. The levels of cytokines (IL-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IFN-α, IFN-γ, monocyte chemotactic protein [MCP]-1, E-selectin, P-selectin, and soluble intercellular adhesion molecule [sICAM]-1) in the AqH were measured by multiplex beads immunoassay...
February 1, 2018: Investigative Ophthalmology & Visual Science
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
Takashi Omoto, Toshihiro Sakisaka, Tetsuya Toyono, Junko Yoshida, Rika Shirakawa, Takashi Miyai, Satoru Yamagami, Tomohiko Usui
PURPOSE: To investigate the clinical results of Descemet stripping automated endothelial keratoplasty (DSAEK) for failed penetrating keratoplasty (PK) and the influence of the graft-host junction (GHJ) on the graft survival rate. METHODS: Data were retrospectively collected on patient demographics, visual outcomes, complications, and graft survival rate for 17 eyes of 16 patients who underwent DSAEK for failed PK. The graft survival rate was compared between the eyes when divided into a bump group and a well-aligned group according to the shape of the GHJ detected on anterior segment optical coherence tomography...
April 2018: Cornea
Steven S Bae, Isaac Menninga, Richard Hoshino, Christine Humphreys, Clara C Chan
PURPOSE: The purpose of this study was to develop a nomogram to predict postcut thickness of corneal grafts prepared at an eye bank for Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Retrospective chart review was performed of DSAEK graft preparations by 3 experienced technicians from April 2012 to May 2017 at the Eye Bank of Canada-Ontario Division. Variables collected included the following: donor demographics, death-to-preservation time, death-to-processing time, precut tissue thickness, postcut tissue thickness, microkeratome head size, endothelial cell count, cut technician, and rate of perforation...
January 25, 2018: Cornea
Jacqueline Beltz, Silvana Madi, Yoav Nahum, Paolo Santorum, Massimo Busin
AIM: To evaluate the efficacy of a technical modification to reduce the incidence of traumatic cataract induced by Descemet stripping automated endothelial keratoplasty (DSAEK) performed in phakic eyes. METHODS: A retrospective cohort study. The records of all patients with a clear crystalline lens and endothelial failure that underwent modified DSAEK at our insitution were reviewed. In this modification, in order to avoid inadvertent touch of the insertion forceps against the exposed crystalline lens while passing across the anterior chamber, the incision sites were shifted from the standard 9 and 3 o'clock positions, superiorly to the 10 and 2 o'clock position respectively...
2018: International Journal of Ophthalmology
Koji Kitazawa, Passara Jongkhajornpong, Tsutomu Inatomi, Noriko Koizumi, Kanae Kayukawa, Koichi Wakimasu, Chie Sotozono, Shigeru Kinoshita
BACKGROUND/AIMS: To investigate the efficacy of topical ganciclovir (GCV) for preventing disease recurrence and improving the surgical outcome post-Descemet's stripping automated endothelial keratoplasty (DSAEK) in patients with cytomegalovirus (CMV) endotheliitis. METHODS: This prospective, non-comparative case series study involved six eyes of six patients with endothelial decompensation due to CMV endotheliitis who underwent DSAEK, followed by a continuous, four to six times daily, topical administration of 0...
January 23, 2018: British 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
Sotiria Palioura, Kavitha Sivaraman, Madhura Joag, Adam Sise, Juan F Batlle, Darlene Miller, Edgar M Espana, Guillermo Amescua, Sonia H Yoo, Anat Galor, Carol L Karp
PURPOSE: To report 2 cases with late postoperative Candida albicans interface keratitis and endophthalmitis after Descemet stripping automated endothelial keratoplasty (DSAEK) with corneal grafts originating from a single donor with a history of presumed pulmonary candidiasis. METHODS: Two patients underwent uncomplicated DSAEK by 2 corneal surgeons at different surgery centers but with tissue from the same donor and were referred to the Bascom Palmer Eye Institute with multifocal infiltrates at the graft-host cornea interface 6 to 8 weeks later, and anterior chamber cultures that were positive for the same genetic strain of C...
January 4, 2018: Cornea
Konstantinos Droutsas, Apostolos Lazaridis, Eleftherios Giallouros, Georgios Kymionis, Klio Chatzistefanou, Walter Sekundo
PURPOSE: To compare the course of Scheimpflug corneal densitometry (CD) after Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Fifty-four DMEK and 25 DSAEK cases without previous corneal surgery, complicated intraoperative or postoperative course, or vision-limiting ocular comorbidities were included. Pseudophakic eyes of age-matched subjects were recruited as controls (n = 20). Scheimpflug CD of the optically relevant zones (0-2 and 2-6 mm), best-corrected visual acuity (BCVA), endothelial cell density, and central corneal thickness were evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively...
January 3, 2018: Cornea
Bo-I Ku, Yi-Ting Hsieh, Fung-Rong Hu, I-Jong Wan, Wei-Li Chen, Yu-Chih Hou
PURPOSE: To compare endothelial cell density (ECD) loss rates in penetrating keratoplasty (PKP), Descemet's stripping automated endothelial keratoplasty (DSAEK), and deep anterior lamellar keratoplasty (DALK). DESIGN: Single-center, multiple-surgeon, retrospective cohort study. MATERIALS AND METHODS: Patients who received PKP, DSAEK, or DALK from 2009 to 2014 were analyzed (68 vs. 38 vs. 11 patients, respectively). We excluded patients with therapeutic PKP or regraft, infection, endothelial rejection, or uncontrolled glaucoma...
October 2017: Taiwan Journal of Ophthalmology
Haifa A Madi, Stephen J Morgan, Saurabh Ghosh
Purpose: We report a case of corneal endothelial graft failure secondary to dexamethasone intravitreal implant (Ozurdex™) migration into the anterior chamber (AC). Observations: A 53-year-old man with a history of bilateral idiopathic chronic uveitis, had a right anterior vitrectomy and AC intraocular lens (ACIOL) with a peripheral iridotomy. He received an intravitreal Ozurdex™ implant for right cystoid macular oedema (CMO). Three months later he developed pseudophakic bullous keratopathy and underwent a Descemet stripping automated endothelial keratoplasty (DSAEK), combined with IOL exchange (ACIOL explantation followed by scleral fixated posterior chamber IOL)...
December 2017: American Journal of Ophthalmology Case Reports
M Hermina Strungaru, Asim Ali, David Rootman, Kamiar Mireskandari
Purpose: To report a case of endothelial keratoplasties (EKs) performed in a 4 month old with a posterior polymorphous corneal dystrophy. Observations: A 4 month old infant underwent Descemet membrane endothelial keratoplasty (DMEK) for posterior polymorphous corneal dystrophy. The graft was found to be dislocated on day 5 post-operatively and an attempt to unfold the DMEK scroll and re-bubble was not successful. The patient was then treated successfully with bilateral Descemet stripping automated endothelial keratoplasty (DSAEK)...
September 2017: American Journal of Ophthalmology Case Reports
M Ao, Y Feng, G Xiao, Y Xu, J Hong
PurposeTo evaluate the clinical outcome of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with iridocorneal endothelial (ICE) syndrome.Patients and methodsA retrospective case series study was conducted. Eighteen consecutive Chinese patients with 20 DSAEK grafts were enrolled. Participants were evaluated by anterior segment optical coherence tomography and confocal microscopy. Postoperative complications, graft survival, endothelial cell counts, corneal thickness, and anterior chamber depth were analysed...
December 15, 2017: Eye
Yun Feng, Hong-Qiang Qu, Jing Ren, Philipp Prahs, Jing Hong
BACKGROUND: Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery offers a more standardized approach and reliable method to create corneal grafts with an instrument such as a microkeratome. With the development of Descemet's membrane endothelial keratoplasty, an excellent clinical outcome is seen in the treatment of corneal endothelial dysfunctions, which indicates that thinner corneal graft results in better clinical outcome. With the recent development of the femtosecond laser, ultrathin corneal graft preparation has become possible...
December 20, 2017: Chinese Medical Journal
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