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Descemet's membrane

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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/29781926/repeatability-and-intersession-reproducibility-of-pentacam-corneal-thickness-maps-in-fuchs-dystrophy-and-endothelial-keratoplasty
#2
David Mingo-Botín, Francisco Arnalich-Montiel, Ana Couceiro de Juan, Sara Ortiz-Toquero
PURPOSE: To assess intrasession repeatability and intersession reproducibility of Pentacam corneal thickness maps in patients with Fuchs endothelial corneal dystrophy (FECD) before and after endothelial transplantation. METHODS: In this observational diagnostic evaluation, 20 healthy subjects along with 81 consecutive patients were examined. Patients were classified into 4 groups: FECD without corneal edema, FECD with corneal edema, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29780950/extreme-descemet-s-membrane-rupture-with-hydrops-in-keratoconus-clinical-and-histological-manifestations
#3
I-Ping Loh, Jennifer C Fan Gaskin, Trevor Sherwin, Charles N J McGhee
Purpose: To study the clinical and histological manifestations of an extreme Descemet's membrane rupture as a result of keratoconus. Observations: Using Periodic acid-Schiff assay to study a keratoconic cornea with an extreme rupture showed that the ruptured Descemet's membrane had retracted and folded into scrolls and ridges. The dimensions of the rupture were estimated to be 3.7mm2 , and the central cornea was extremely thinned with a thickness of only 260μm...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29780931/case-of-progressive-hyperopia-due-to-flattening-of-cornea
#4
Hiromasa Hirai, Shinji Maruoka, Tadanobu Yoshikawa, Nahoko Ogata
Purpose: To report a case that had a progressive decrease in the visual acuity caused by a progressive increase in the hyperopia due to a flattening of the cornea. Observations: A 50-year-old woman complained of decreased vision in both eyes. Her decimal best-corrected visual acuity was 1.2 in the right and 0.5 in the left eyes, and the refractive error (spherical equivalent) was +3.75 diopters (D) for the right eye and +6.5 D for the left eye. Slit-lamp examinations showed clear corneas but Descemet's folds and fine pigmentations and opacities were present beneath the corneal epithelium in both eyes...
June 2018: American Journal of Ophthalmology Case Reports
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
#5
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
#6
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
#7
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/29738588/comparison-of-surgically-induced-astigmatism-and-morphologic-features-resulting-from-femtosecond-laser-and-manual-clear-corneal-incisions-for-cataract-surgery
#8
Tiago B Ferreira, Filomena J Ribeiro, João Pinheiro, Paulo Ribeiro, João G O'Neill
PURPOSE: To compare the surgically induced astigmatism (SIA) vector, flattening effect, torque, and wound architecture following femtosecond laser and manual clear corneal incisions (CCIs). METHODS: In a double-armed, randomized, prospective case series, cataract surgery was performed for 600 eyes using femtosecond laser (300 eyes) or manual (300 eyes) 2.4-mm CCIs in temporal or superior oblique locations. SIA, flattening effect, torque, and the summated vector mean for SIA were calculated...
May 1, 2018: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/29737973/in-vivo-endothelial-cell-density-decline-in-the-early-postoperative-phase-after-descemet-membrane-endothelial-keratoplasty
#9
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
#10
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/29723889/medical-and-semi-surgical-treatments-for-fuchs-endothelial-corneal-dystrophy
#11
Katrin Wacker, Keith H Baratz, Michael P Fautsch, Sanjay V Patel
Unraveling the genetic mechanisms of Fuchs endothelial corneal dystrophy has opened new possibilities for future targeted medical therapy of the disease. Until these possibilities mature, regenerative semi-surgical approaches by cell injection or cell sheet transfer could help expand the donor pool, and possibly enable autologous transplantation. Descemet membrane stripping alone and acellular Descemet membrane transfer are more immediate surgical approaches that could be temporary treatments in some patients, though there is a lack of understanding of the factors that predict success for these procedures...
May 3, 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29708936/frequency-of-complications-during-preparation-of-corneal-lamellae-used-in-posterior-lamellar-keratoplasty-using-the-pneumodissection-technique-big-bubble
#12
Pavel Studeny, Magdalena Netukova, Martin Hlozanek, Jan Bednar, Katerina Jirsova, Deli Krizova
PURPOSE: To determine the frequency of formation of various types of bubbles and the potential impact of donor and lamella parameters on this frequency, and to identify possible risk factors of unsuccessful "big-bubble" creation in preparation of pre-Descemet endothelial keratoplasty and Descemet membrane endothelial keratoplasty with peripheral stromal support. METHODS: Donor age and sex, death to preservation time (DPT), storage time, presence of corneal scars (mainly a condition after cataract surgery), and endothelial cell density of 256 donor corneas were assessed before Descemet membrane endothelial keratoplasty with peripheral stromal support or pre-Descemet endothelial keratoplasty lamella preparation using the big-bubble technique...
April 26, 2018: Cornea
https://www.readbyqxmd.com/read/29681841/triamcinolone-acetonide-assisted-descemetectomy-for-retained-descemet-membrane
#13
Ariel Tyring, Oliver Chang, Hoon Jung
We present a case of decreased vision due to the presence of retained Descemet membrane (DM) following Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP). A 78-year-old male presented postoperatively from PKP after previous failed DSAEK with retained DM. We present a unique technique for combined surgical resection using bimanual vitrectomy and forceps excision assisted by triamcinolone acetonide for membrane visualization. Histopathological evaluation confirmed incomplete DM removal during the PKP...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29673628/-descemet-s-membrane-endothelial-keratoplasty-indication-surgical-technic-postoperative-management-and-review-of-literature
#14
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
#15
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
#16
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/29664749/meta-analysis-of-descemet-membrane-endothelial-keratoplasty-versus-descemet-stripping-automated-endothelial-keratoplasty-postoperative-visual-outcomes
#17
https://www.readbyqxmd.com/read/29661044/dmek-versus-dsaek-for-fuchs-endothelial-dystrophy-a-meta-analysis
#18
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
#19
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
#20
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
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