Fluid misdirection syndrome associated with endothelial keratoplasty: A multicenter case series

Lorente, M. García; Rocha‐de‐Lossada, Carlos; Borroni, Davide; Romano, Vito; Urbinati, Facundo; Zamorano‐Martin, Francisco; Peraza‐Nieves, Jorge; Rodríguez‐Calvo‐de‐Mora, Marina

doi:10.1111/ceo.14117

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…13,14 The main known risk factors for IAMS are small hyperopic eyes with shallow AC and a short axial length, and lax zonular fibres. 14,15 Additionally, there are other suggested potential risk factors, such as a history of IAMS in the fellow eye, nanophthalmos, plateau iris syndrome, larger natural lenses, and elevated intraocular pressure before surgery. 16 The exact comprehension of the pathophysiology behind IAMS remains elusive.…”

Section: Discussionmentioning

confidence: 99%

“…24 Although IAMS has been described as a complication mainly related to trabeculectomy and cataract surgery, 16 several cases associated with endothelial keratoplasty (EK) have been reported. 15,25,26 In EK procedures, IAMS most frequently occurs during irrigation with BSS while maintaining the AC during DSAEK graft insertion or unfolding the graft during DMEK. 15 Currently, the best intraoperative management approach for IAMS is still subject to debate.…”

Section: Discussionmentioning

confidence: 99%

“…15,25,26 In EK procedures, IAMS most frequently occurs during irrigation with BSS while maintaining the AC during DSAEK graft insertion or unfolding the graft during DMEK. 15 Currently, the best intraoperative management approach for IAMS is still subject to debate. Before proceeding with the surgery, suprachoroidal haemorrhage must always be excluded.…”

Section: Discussionmentioning

confidence: 99%

“…15,25,26 In EK procedures, IAMS most frequently occurs during irrigation with BSS while maintaining the AC during DSAEK graft insertion or unfolding the graft during DMEK. 15…”

Section: Discussionmentioning

confidence: 99%

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Double trouble in DMEK surgery: Learning experience and review of the literature

Romano,

Passaro,

Airaldi

et al. 2024

European Journal of Ophthalmology

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Purpose To report a challenging Descemet Membrane Endothelial Keratoplasty (DMEK) case, complicated by intraoperative aqueous misdirection and spontaneous anterior chamber fibrin reaction. Methods A 70-year-old female affected by corneal edema due to Fuchs endothelial dystrophy underwent a triple procedure (cataract extraction - IOL implantation - DMEK surgery) in her left eye. This report illustrates the management of the intraoperative complications of aqueous misdirection syndrome and anterior chamber fibrin reaction. Results Despite the optimal management of the posterior pressure and the thorough removal of the fibrinous reaction during the case, the DMEK graft was not completely unfolded and centred at the end of the surgical procedure. Nonetheless, the patient showed good long-term anatomical and functional recovery: at the last follow-up (2 years after surgery), central corneal thickness was 526 µm with a best corrected visual acuity of 20/25 and an endothelial cell density of 1112 cell/mm2. Conclusion Early recognition and prompt management of intraoperative aqueous misdirection syndrome and anterior chamber fibrin reaction during DMEK surgery is essential to ensure good functional and anatomical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…15,25,26 In EK procedures, IAMS most frequently occurs during irrigation with BSS while maintaining the AC during DSAEK graft insertion or unfolding the graft during DMEK. 15…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Double trouble in DMEK surgery: Learning experience and review of the literature

Romano,

Passaro,

Airaldi

et al. 2024

European Journal of Ophthalmology

Self Cite

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Incidence and management of early postoperative complications in lamellar corneal transplantation

Romano¹,

Aiello²,

Parekh³

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose To provide a comprehensive review of the incidence, risk factors, and management of early complications after deep anterior lamellar keratoplasty (DALK), Descemet stripping automated keratoplasty (DSAEK), and Descemet membrane endothelial keratoplasty (DMEK). Methods A literature review of complications, that can occur from the time of the transplant up to 1 month after the transplant procedure, was conducted. Case reports and case series were included in the review. Results Complications in the earliest postoperative days following anterior and posterior lamellar keratoplasty have shown to affect graft survival. These complications include, but are not limited to, double anterior chamber, sclerokeratitis endothelial graft detachment, acute glaucoma, fluid misdirection syndrome, donor-transmitted and recurrent infection, and Uretts-Zavalia syndrome. Conclusion It is essential for surgeons and clinicians to not only be aware of these complications but also know how to manage them to minimize their impact on long-term transplant survival and visual outcomes.

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Fluid misdirection syndrome associated with endothelial keratoplasty: A multicenter case series

Cited by 2 publications

References 5 publications

Double trouble in DMEK surgery: Learning experience and review of the literature

Double trouble in DMEK surgery: Learning experience and review of the literature

Incidence and management of early postoperative complications in lamellar corneal transplantation

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