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Hideaki Yokogawa, Akira Kobayashi, Natsuko Mori, Tsubasa Nishino, Toshinori Masaki, Kazuhisa Sugiyama; De novo iris abnormality after Descemet membrane endothelial keratoplasty and its impact on postoperative clinical outcomes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1310.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to elucidate the frequency of de novo iris abnormality after Descemet membrane endothelial keratoplasty (DMEK) and its impact on postoperative clinical outcomes.
In this retrospective case series, medical records of consecutive 32 eyes of 28 patients (mean age, 65.7 ± 13.4 year, 14 men, 18 women) who underwent DMEK (or triple DMEK) in our hospital was reviewed. In all patients, inferior peripheral iridectomy was created leaving full intracameral air tamponade at the end of surgery. SF6 gas was not used in any cases. De novo iris abnormality such as pupillary shape change and iris depigmentation was evaluated by 3 independent observers in a masked fashion. Pre-existing iris abnormality was excluded. Eyes were divided into two groups based on presence of these de novo iris changes; Group A (with iris abnormality) and Group B (no iris abnormality). Impact on postoperative clinical outcomes such as visual outcomes and endothelial cell density between two groups were analyzed.
De novo iris abnormality was seen in 15 eyes (9 eyes with pupillary shape change and 6 eyes with iris depigmentation, =group A, 46.9%), and were not seen in 17 eyes (=Group B, 53.1%). No differences were detected between Group A and Group B, in age (p = 0.60), sex (p = 0.31), indication (p = 0.13), simultaneous cataract surgery (p = 0.40), pre- and 6 months postoperative vision (p = 0.11 and 0.78), donor age (p = 0.52), and donor and 6 months postoperative endothelial cell density (p = 0.66 and 0.54).
De novo iris abnormality was noted in almost half number of eyes after DMEK (46.9%). However, visual outcomes and postoperative endothelial cell density were not affected by these iris changes at least 6 months postoperatively.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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