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K. Laaser, B. O. Bachmann, C. Cursiefen, F. E. Kruse; Rebubbling Does Not Adversely Change the Outcome of DMEK During Early Postoperative Follow Up. Invest. Ophthalmol. Vis. Sci. 2010;51(13):753.
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© ARVO (1962-2015); The Authors (2016-present)
Descemet membrane endothelial keratoplasty (DMEK) allows the sole replacement of diseased corneal endothelium. A major complication after DMEK is graft failure following detachment (compete or partial). Here we investigate the effect of air injections into the anterior chamber during the early postoperative period on the functional and morphological success after DMEK.
DMEK was performed in 34 patients with Fuchs endothelial dystrophy. Best corrected visual acuity (BCVA) and Endothelial cell density (ECD; SeaEagle® Specular Microscope) in donor tissue were evaluated before and 1 month after transplantation.
73.6% of our patients needed air injections in the early postoperative stage due to partial donor detachment. 19 patients received one air injection (55.9%), 4 patients received 2 air injections (11.8%), 2 patients received 3 air injections (5.9%) and 9 patients did not need any air injection (26.5%). The BSCVA increased from 0.23 preoperative to 0.47 one month after surgery in the whole group (p ≤ 0,001). During the same period the BSCVA increased from 0.13 to 0.45, from 0.17 to 0.45, from 0.18 to 0.46 and from 0.35 to 0.75 in patients with 0, 1, 2 and 3 air injection respectively. The mean ECD decreased from 2613 ± 236 cells/cm2 to 1585 ± 331 cells/cm2 (p < 0,005). During the same period the ECD decreased from 2540 to 1613, from 2594 to 1474, from 2517 to 1893 and from 2834 to 1652 cells/cm2 in patients with 0, 1, 2 and 3 air injection respectively.
Our results suggest that air injections do not decrease visual outcome or ECD. Therefore early rebubbling is suggested to spead up visual recovery and ensure full anatomical restoration after DMEK.
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