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Thomas Ziegler, Friedrich E Kruse, Johannes Menzel-Severing, Julia Marina Weller, Theofilos Tourtas; DMEK: Is tight scrolling a risk factor for graft detachment?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1199.
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© 2017 Association for Research in Vision and Ophthalmology.
Graft detachment remains the most frequent complication after DMEK surgery. Differences in the degree of scrolling of grafts after stripping might influence graft adhesion. Here we ask if the scroll formation of the graft has an impact on rebubbling rates.
A retrospective analysis of 291 consecutive grafts prepared for DMEK surgery was performed. 156 grafts were prepared from organ-cultured corneoscleral buttons (Dulbecco's Modified Eagle's Medium at 34°C, Biochrom, Berlin, Germany) and 135 grafts were prepared from short-term cultured corneoscleral buttons (Optisol-GS at 4°C, Bausch & Lomb, Irvine, CA, USA). Based on the degree of scrolling (width of the graft roll measured by using a caliper immediately after graft preparation) grafts were divided into three groups (group I: width ≤ 1.3 mm; group II: width 1.4 – 1.9 mm; group III: width ≥ 2.0 mm). As graft orientation was equal and surgery time was comparable in all groups (p>0.05), we excluded influence of intraoperative graft manipulation and positioning on graft detachment.
There was no significant difference between organ-culture and Optisol concerning donor endothelial cell count (p>0.05). Mean donor age in organ-culture (70 ± 8 years) was significantly higher than in Optisol (64 ± 6 years; p<0.05). In both culture methods the positive correlation between the width of the graft and donor age was confirmed (organ-culture: r=0.5; Optisol: r=0.5; p<0.05). In organ-cultured grafts overall rebubbling rate was 6.4% (10/156): group I: 5.3% (3/57), group II: 6.8% (3/44) and group III: 7.3% (4/55). In Optisol overall rebubbling rate was 13.3% (18/135): group I: 17.6% (12/68), group II: 7.9% (3/38) and group III: 10.3% (3/29). Difference of rebubbling rates between the three groups of graft scrolling was statistically not significant neither in organ-cultured grafts nor in Optisol grafts (Fisher's exact test; p>0.05).
Our results suggest that the degree of graft scrolling has no influence on rebubbling rate neither in the organ-culture group nor in the Optisol group.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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