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Bjoern O. Bachmann, Kathrin Laaser, Claus Cursiefen, Friedrich E. Kruse; Functional And Morphological Outcome After DMEK In Patients With Graft Failure Following DSAEK. Invest. Ophthalmol. Vis. Sci. 2011;52(14):770.
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© ARVO (1962-2015); The Authors (2016-present)
Descemet membrane endothelial keratoplasty (DMEK) is a new technique for the replacement of diseased corneal endothelium by healthy donor endothelium resulting in an interface between the host corneal stroma and the donor’s Descemet’s membrane. There is only little evidence indicating that this technique is suitable for the treatment of failed grafts after Descemet's stripping automated endothelial keratoplasty (DSAEK).
DMEK was performed as previously described in 7 patients with graft failure after DSAEK using a standardized technique for graft preparation and transplantation. During surgery DSAEK grafts were removed by using a forceps. Visual acuity, Endothelial cell density, anterior chamber OCT and pachymetry were retrospectively assessed for the functional and morphological follow up.
Grafting was uneventful in all procedures. One patient developed a partial graft detachment necessitating rebubbling during the postoperative time course. Anterior chamber OCT confirmed adhesion of the remaining grafts. Mean visual acuity (logMAR) increased from 1.57 +/- 0.75 preoperatively to 0.09 +/- 0.66 three months after DMEK (p<0.004). Endothelial cell density decreased by 35 % within the first month after surgery followed by a further slight decrease the following 2 months. Pachymetry decreased from 841 +/- 241 µm preoperatively to 481 +/- 65 µm (p<0.001) 3 months postoperatively.
A stroma-stroma interface after previous DSAEK can be converted to a stable Descmet’s membrane-stroma interface of high optical quality by DMEK.
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