Sophie X Deng1, P James Sanchez2, Luxia Chen2. 1. Cornea Division, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, California. Electronic address: deng@jsei.ucla.edu. 2. Cornea Division, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, California.
Abstract
PURPOSE: To investigate the outcomes of Descemet membrane endothelial keratoplasty (DMEK) using prestripped donor tissue prepared by an eye bank. DESIGN: Retrospective, noncomparative case series. METHODS: This retrospective, noncomparative, observational study investigated the outcomes of the first 40 consecutive DMEK procedures performed by a single surgeon using prestripped tissues prepared by a single eye bank during the period September 17, 2013 to July 1, 2014. A new technique to unfold the Descemet membrane grafts using a single cannula was described. Medical records were reviewed to obtain the prestripped and poststripped endothelial cell counts (ECC), postoperative ECC, visual acuity measurements, and complications. RESULTS: Of the 43 prestripped tissues received, 40 were transplanted. The leading indications for DMEK were Fuchs endothelial corneal dystrophy (n = 28) and bullous keratopathy (n = 11). Nine DMEK procedures were performed in combination with phacoemulsification and posterior chamber intraocular lens implantation. Six patients had undergone prior glaucoma surgeries. The mean follow-up duration was 5.3 months (range, 1 week to 11 months). Preoperative spectacle-corrected visual acuity was ≤20/200 in 8 patients (20%) and ≤20/40 in 37 patients (92.5%). Primary graft failure occurred in the first case. Thirty-eight patients had improved vision postoperatively. Among the 39 patients who had successful DMEK, postoperative BCVA was ≥20/20 in 20 patients (51.2%), ≥20/25 in 30 patients (76.9%), and ≥20/40 in 34 patients (87.2%) by the last follow-up. There was no secondary graft failure. Rejection occurred in 2 patients because of self-discontinuation of topical corticosteroid. The most common complication was partial detachment requiring air injection (11 of 40 patients; 27.5%). Mean ECC loss after stripping of Descemet membrane was 3.9% (range, 6.5% gain to 14.5% loss). During the first 6 months after transplantation, the average ECC loss was 30.5% (range, 3.8%-67.4% loss). CONCLUSIONS: DMEK using eye bank-prepared tissue achieved outcomes comparable to those reported for DMEK using surgeon-prepared tissue. Published by Elsevier Inc.
PURPOSE: To investigate the outcomes of Descemet membrane endothelial keratoplasty (DMEK) using prestripped donor tissue prepared by an eye bank. DESIGN: Retrospective, noncomparative case series. METHODS: This retrospective, noncomparative, observational study investigated the outcomes of the first 40 consecutive DMEK procedures performed by a single surgeon using prestripped tissues prepared by a single eye bank during the period September 17, 2013 to July 1, 2014. A new technique to unfold the Descemet membrane grafts using a single cannula was described. Medical records were reviewed to obtain the prestripped and poststripped endothelial cell counts (ECC), postoperative ECC, visual acuity measurements, and complications. RESULTS: Of the 43 prestripped tissues received, 40 were transplanted. The leading indications for DMEK were Fuchs endothelial corneal dystrophy (n = 28) and bullous keratopathy (n = 11). Nine DMEK procedures were performed in combination with phacoemulsification and posterior chamber intraocular lens implantation. Six patients had undergone prior glaucoma surgeries. The mean follow-up duration was 5.3 months (range, 1 week to 11 months). Preoperative spectacle-corrected visual acuity was ≤20/200 in 8 patients (20%) and ≤20/40 in 37 patients (92.5%). Primary graft failure occurred in the first case. Thirty-eight patients had improved vision postoperatively. Among the 39 patients who had successful DMEK, postoperative BCVA was ≥20/20 in 20 patients (51.2%), ≥20/25 in 30 patients (76.9%), and ≥20/40 in 34 patients (87.2%) by the last follow-up. There was no secondary graft failure. Rejection occurred in 2 patients because of self-discontinuation of topical corticosteroid. The most common complication was partial detachment requiring air injection (11 of 40 patients; 27.5%). Mean ECC loss after stripping of Descemet membrane was 3.9% (range, 6.5% gain to 14.5% loss). During the first 6 months after transplantation, the average ECC loss was 30.5% (range, 3.8%-67.4% loss). CONCLUSIONS: DMEK using eye bank-prepared tissue achieved outcomes comparable to those reported for DMEK using surgeon-prepared tissue. Published by Elsevier Inc.
Authors: Annekatrin Rickmann; Karl Boden; Silke Wahl; Andre Trouvain; Andre Schulz; Peter Szurman Journal: Int Ophthalmol Date: 2021-10-21 Impact factor: 2.031
Authors: Friso G Heslinga; Ruben T Lucassen; Myrthe A van den Berg; Luuk van der Hoek; Josien P W Pluim; Javier Cabrerizo; Mark Alberti; Mitko Veta Journal: Sci Rep Date: 2021-07-07 Impact factor: 4.379