June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Descemet membrane endothelial keratoplasty (DMEK) in the management of late spontaneous detachment of Descemet’s membrane after penetrating keratoplasty
Author Affiliations & Notes
  • Theofilos Tourtas
    Department of Ophthalmology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany
  • Julia M. Weller
    Department of Ophthalmology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany
  • Ursula Schlötzer-Schrehardt
    Department of Ophthalmology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany
  • Friedrich E. Kruse
    Department of Ophthalmology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern, Germany
  • Footnotes
    Commercial Relationships   Theofilos Tourtas None; Julia Weller None; Ursula Schlötzer-Schrehardt None; Friedrich Kruse None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4789. doi:
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      Theofilos Tourtas, Julia M. Weller, Ursula Schlötzer-Schrehardt, Friedrich E. Kruse; Descemet membrane endothelial keratoplasty (DMEK) in the management of late spontaneous detachment of Descemet’s membrane after penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4789.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the feasibility of Descemet membrane endothelial keratoplasty (DMEK) as a treatment option in the management of late, spontaneous detachment of Descemet’s membrane after penetrating keratoplasty (PK) for keratoconus.

Methods : This was a single-center, retrospective case series of 5 eyes of 4 patients undergoing DMEK for late, spontaneous detachment of Descemet’s membrane after PK for keratoconus. Main outcome measures included visual acuity, endothelial cell density and need for rebubbling after surgery. In addition, anterior segment imaging and histological findings are presented.

Results : Median interval between PK and occurrence of Descemet’s membrane detachment was 33 years (range 29-45 years). Air injections into the anterior chamber were initially attempted to re-attach DM in all eyes, which had no long-lasting effect. DMEK was performed successfully in all eyes leading to increase of visual acuity and resolution of corneal edema. 3 out of 5 eyes needed one rebubbling postoperatively. Endothelial cell density ranged between 1208 and 1530 cells/mm2 1 year after DMEK. There were no signs of retrocorneal membrane formation or fibrosis in light microscopy and transmission electron microscopy.

Conclusions : This is the first report of DMEK for eyes with late, spontaneous Descemet’s membrane detachment after PK. Our results provide evidence that DMEK is a viable option for the management of this condition with good clinical outcome.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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