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Max Weiling, Julia Marina Weller, Friedrich E Kruse, Theofilos Tourtas; Triple-DMEK: Effect of viscoelastic on graft adhesion after surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1198.
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© ARVO (1962-2015); The Authors (2016-present)
Viscoelastic to stabilize the anterior chamber for cataract surgery is routinely used during Triple-DMEK. The first step of descemetorhexis - scoring of the host's Descemet's membrane with the inverted Sinskey hook- can be either performed prior to cataract surgery while the anterior chamber is filled with viscoelastic or under air after cataract surgery following complete removal of viscoelastic. Our aim is to analyze if the use of viscoelastic has an influence on graft adhesion and rebubbling rates.
Retrospective analysis of 200 Triple-DMEKs performed for Fuchs endothelial dystrophy between July 2014 and November 2015. Based on the use of viscoelastic (Z-HYALON PLUS, Carl Zeiss Meditec AG, Hennigsdorf, Germany) during descemetorhexis patients were divided into two groups. In order to exclude the known effect of splitting of either the Descemet's membrane of the graft or recipient on graft adhesion, grafts as well as recipients with splitting were excluded from this study (n=11). 189 patients (n=93 with viscoelastic; n=96 without viscoelastic) could be incorporated into the study.
There were no statistically significant differences regarding recipients' age, donors' age and gender distribution. Rebubbling rate in eyes in which the viscoelastic was present during descemetorhexis was 8.6 % and in eyes without viscoelastic 3.1%. Although there was a decrease in rebubbling rates this difference was not statistically significant between the two groups (p=0.108, chi-square-test). Rebubbling was performed after 12 ± 7.8 days in eyes with viscoelastic and after 11.67 ± 9.8 days in eyes without viscoelastic (p=0.954, t-test).
Our results show that using viscoelastic during descemetorhexis in Triple-DMEK has no influence on graft adhesion and rebubbling rates. As a consequence, viscoelastic can routinely be used in Triple-DMEK to facilitate the step of descemetorhexis.
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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