Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty

Kemer, Özlem Evren; Karaca, Emine Esra; Oellerich, Silke; Melles, Gerrit R.J.

doi:10.4274/tjo.galenos.2021.28227

Cited by 12 publications

(13 citation statements)

References 83 publications

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“…On another note, there are also the technical challenges when inserting the lamellar donor tissue, surgical step that requires very specific training [31,32]. Hence some eye banks have providing precut and pre-stripped donor corneal tissue for DMEK [33].…”

Section: Plos Onementioning

confidence: 99%

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Indications and techniques of corneal transplants performed in one center in Southern Poland, in the years 2001–2020

et al. 2022

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Purpose The study aimed to evaluate changes over a period of time in techniques and indications for corneal transplantation in a single center in Poland. Methods Retrospective analysis of corneal transplants performed at the Ophthalmology Department of the District Railway Hospital in Katowice in 2001–2020. Data on indications and surgical technique were collected. Results A total of 3021 corneal transplantations were performed in the years 2000–2020. The most common technique was penetrating keratoplasty (69,54%), then lamellar grafts—both anterior and posterior (19,63%), and limbal grafts (10,82%). Only in 2007 the number of lamellar keratoplasties exceeded the number of penetrating grafts and accounted for 108 (54,55%), including 85 (42,93%) of Descemet Stripping Automated Endothelial Keratoplasty. The only noticeable trend in changing techniques was a decrease in the number of performed deep anterior lamellar keratoplasties (r 2 = -0.21) over the last seven years. Main indications included bullous keratopathy (23,22%), following keratoconus (18,59%), leukoma (14,67%), keratitis and perforation (14,3%), Fuchs dystrophy (11,4%), and regrafts (7,22%). Leukoma and bullous keratopathy as an indications for corneal transplant have been declining over the years (r2 = 0.60 and r2 = 0.30 respectively). Consecutively, indications such as fuchs dystrophy, regraft and keratitis perforation have increased (r2 = 0.05, r2 = 0.50, r2 = 0.33) Conclusions The number of keratoplasties gradually increased from 2001 to 2020. It could be possible that the development and spread of new therapeutic alternatives, like corneal cross-linking and scleral lenses, have contributed to the decrease in deep anterior lamellar keratoplasty performed. There was an increasing trend in the percentage of penetrating keratoplasties for failed grafts, Fuchs dystrophy and infectious keratitis.

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Section: Plos Onementioning

confidence: 99%

“…PKP presents several drawbacks, including postoperative astigmatism, corneal wound dehiscence, allograft rejection, and early and late endothelial failure [31]. Therefore, it is substantial to strive to perform more lamellar keratoplasties.…”

Section: Plos Onementioning

confidence: 99%

Indications and techniques of corneal transplants performed in one center in Southern Poland, in the years 2001–2020

et al. 2022

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“…[ 11 ] An irregular posterior corneal surface, as may occur in older penetrating keratoplasties or cornea trauma, may also make DMEK adherence more difficult. [ 12 ] Furthermore, as DMEK grafts tend to scroll tightly, they can be small enough to drop into the vitreous in eyes with aphakia or large iris defects. Finally, maintaining a good sized air/gas bubble and a pressurized anterior chamber in vitrectomized eyes and those with prior glaucoma filtration surgery can be challenging and hence such eyes may be more suitable for DSAEK.…”

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confidence: 99%

“…Finally, maintaining a good sized air/gas bubble and a pressurized anterior chamber in vitrectomized eyes and those with prior glaucoma filtration surgery can be challenging and hence such eyes may be more suitable for DSAEK. [ 12 ]…”

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confidence: 99%