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Lamis Baydoun, Silke Oellerich, Fook Chang Lam, Korine Van Dijk, Gerrit Melles; Quantitative assessment of aqueous flare after DMEK shows persistent subclinical inflammation. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4780.
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© ARVO (1962-2015); The Authors (2016-present)
With Descemet membrane endothelial keratoplasty (DMEK) less antigenic tissue is transplanted as compared to penetrating keratoplasty. Even though eyes after DMEK may look clinically quiet, there may still be some subclinical inflammation induced by the DMEK transplant. Therefore, we wanted to objectively quantify aqueous flare as a measure of intraocular inflammation in DMEK eyes.
148 DMEK eyes of 148 patients operated on for Fuchs endothelial dystrophy and 19 age-matched healthy control eyes were included in this comparative cross-sectional case series at a tertiary referral center. Aqueous flare was assessed by laser flare photometry on average 27 (±19) months after DMEK (range: 3 - 86 months, median 24 months) and was compared to control eyes.
Average flare was higher in DMEK eyes compared to the healthy controls (9.4 photon count per millisecond (ph/ms), (95% Confidence Interval (CI) 8.7-10.1) versus 6.7 ph/ms (CI 4.5-8.9), respectively (P=.0246), estimated mean difference: -2.71 (CI -5.1-0.35)). Age was significantly associated with flare (P=.0138). For the DMEK group, gender, lens status, presence of diabetes, follow-up time and endothelial cell density were not related to the flare level (P>.05).
Higher aqueous flare levels after DMEK may indicate a persistent subclinical inflammation. Ongoing topical anti-inflammatory treatment may therefore be beneficial. Laser flare photometry may be a potential diagnostic tool to monitor intraocular inflammation levels following DMEK in order to adjust treatment accordingly.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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