Modified Descemet’s stripping automated endothelial keratoplasty for eyes with glaucoma drainage devices and shallow anterior chambers

Vasquez-Perez, Alfonso; Naqib, Syed Mohammed; Nanavaty, Mayank A.

doi:10.1007/s10792-017-0621-4

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Vasquez‐Perez used a 2‐mm skin biopsy punch for trephining the DSAEK donor disk in the periphery, thereby creating a peripheral notch to avoid graft–tube contact (Vasquez‐Perez et al. 2018), which is a similar concept to the 3/4‐DMEK approach described in this study.…”

Section: Discussionmentioning

confidence: 99%

Three‐quarter DMEK in eyes with glaucoma draining devices to avoid secondary graft failure

Oganesyan

Макаров

Grdikanyan

et al. 2020

Acta Ophthalmologica

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Purpose To present a case series of a modified three‐quarter Descemet’s membrane endothelial keratoplasty (3/4‐DMEK) technique to treat pseudophakic bullous keratopathy in the presence of a glaucoma drainage device (GDD) tube in the anterior chamber by reducing the risk of donor endothelial damage due to absence of donor endothelial cells overlying the GGD tube area. Methods In this prospective case series, four eyes of three patients with stable glaucoma underwent 3/4‐DMEK surgery for pseudophakic bullous keratopathy after GDD insertion. The patients were followed up to 24 ± 2.5 months postoperatively. Results No intraoperative or postoperative complications were noted. The average central endothelial cell density (ECD) was 1093 ± 74 cells/mm2 at 12 months postoperatively, corresponding to an ECD decrease of 58 (±6)% as compared to preoperative values. Average best‐corrected visual acuity increased from finger counting before surgery to 20/60 (logMar 0.5) at 12 months after 3/4‐DMEK and remained stable up to 24 months postoperatively. All corneas remained clear at the last available follow‐up. Conclusion This case series demonstrates the technical feasibility of 3/4‐DMEK in eyes with pseudophakic bullous keratopathy in the presence of a GDD tube. The absence of a donor DM and donor cells above the silicone tube excludes direct tube contact with the graft. Longer term studies are needed to show the effect of this modified graft pattern and dimensions on transplant survival.

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Section: Discussionmentioning

confidence: 99%

Three‐quarter DMEK in eyes with glaucoma draining devices to avoid secondary graft failure

Oganesyan

Макаров

Grdikanyan

et al. 2020

Acta Ophthalmologica

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Therapieoptionen bei Endotheldekompensation nach Glaukomchirurgie

Maier

Reinhard

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungSeit einigen Jahren hat sich die Descemet Membrane endothelial Keratoplasty (DMEK) in Deutschland als Methode der ersten Wahl bei Patienten mit Fuchs-Endotheldystrophie und pseudophaker bullöser Keratopathie durchgesetzt. Bei dieser Operationsmethode, bei der die erkrankte Descemet-Membran durch eine Spenderlamelle aus Descemet-Membran und Endothel ersetzt wird, kann es jedoch nach Glaukomoperationen wie der Trabekulektomie oder der Implantation von Drainageimplantaten zu spezifischen intra- und postoperativen Komplikationen kommen. Hierzu zählen die erschwerte Entfaltung der Transplantate durch das Vorhandensein eines Drainageimplantates mit einem entsprechend erhöhten Endothelzellverlust ebenso wie die Gefahr des Verlustes der Luft-/Gastamponade in der Vorderkammer über die Trabekulektomie bzw. das Drainageimplantat mit entsprechend erhöhtem Dislokationsrisiko für das Transplantat. In der folgenden Übersicht soll zunächst auf das Risiko des Endothelzellverlustes nach verschiedenen Glaukomoperationen eingegangen werden und anschließend die Vor- und Nachteile der verschiedenen Transplantationstechniken erörtert sowie mögliche Hilfestellungen zur Verbesserung der Operationstechnik gegeben werden.

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Descemet membrane endothelial keratoplasty after implantation of glaucoma drainage devices

Oganesyan¹,

Макаров²,

Grdikanyan³

et al. 2022

Vestn. oftal'mol.

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Modified Descemet’s stripping automated endothelial keratoplasty for eyes with glaucoma drainage devices and shallow anterior chambers

Abstract: This modified technique of DSAEK offers the benefits of endothelial transplant, and it could represent an option to reduce risks of corneal decompensation due to the presence of tubes in cases with shallow anterior chambers.

Cited by 3 publications

References 18 publications

Three‐quarter DMEK in eyes with glaucoma draining devices to avoid secondary graft failure

Three‐quarter DMEK in eyes with glaucoma draining devices to avoid secondary graft failure

Therapieoptionen bei Endotheldekompensation nach Glaukomchirurgie

Descemet membrane endothelial keratoplasty after implantation of glaucoma drainage devices

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