Four-Year Survival of Descemet Membrane Endothelial Keratoplasty in Patients With Previous Glaucoma Surgery

Sorkin, Nir; Kisilevsky, Eli; Boutin, Tanguy; Cohen, Eyal; Trinh, Tanya; Santaella, Gisella; Slomovic, Allan R.; Rootman, David S.

doi:10.1016/j.ajo.2020.05.020

Cited by 29 publications

(47 citation statements)

References 21 publications

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“…In accordance with previously published results, our analysis demonstrates that DMEK after glaucoma surgery results in an improved visual acuity at acceptable rebubbling rates. However, primary and secondary graft failure rates are increased when comparing to the "classical" DMEK surgery in eyes with Fuchs corneal endothelial dystrophy (FECD) without previous glaucoma surgery [15,[20][21][22]. Alshaker et al demonstrated in a recently published study that both DMEK and DSAEK seem to have decreased survival rates with 75% vs. 75% at 1 year and 28% vs. 29% at 5 years, respectively [23].…”

Section: Discussionmentioning

confidence: 99%

“…Sorkin et al reported a graft survival probability of 75%, 60%, 43%, and 27% in 32 GDD at 12, 24, 36, and 48 months, respectively, compared with a consistent 88% in 19 control group non-GDD eyes ( p < 0.001) [ 21 ]. Recently, Alshaker et al showed in a cohort of 48 DMEK eyes with previous GDD or TE a graft survival of 75% at 1 year, 63% at 2 years, 49% at 3 years, 28% at 4 years, and 28% at 5 years [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery

Schrittenlocher

Grass

Dietlein

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose This study aims to assess the results, rebubbling rate, and graft survival after Descemet membrane endothelial keratoplasty (DMEK) with regard to the number and type of previous glaucoma surgeries. Methods This is a clinical retrospective review of 1845 consecutive DMEK surgeries between 07/2011 and 08/2017 at the Department of Ophthalmology, University of Cologne. Sixty-six eyes were included: group 1 (eyes with previous glaucoma drainage devices (GDD); n = 27) and group 2 (eyes with previous trabeculectomy (TE); n = 39). Endothelial cell loss (ECL), central corneal thickness, graft failure, rebubbling rate, and best spectacle-corrected visual acuity (BSCVA) up to 3 years after DMEK were compared between subgroups of patients with different numbers of and the two most common types of glaucoma surgeries either GDD or TE or both. Results Re-DMEK rate due to secondary graft failure was 55.6% (15/27) in group 1 and 35.9% in group 2. The mean graft survival time in group 1 was 25 ± 11 months and 31.3 ± 8.6 months in group 2 (p = 0.009). ECL in surviving grafts in group 1 was 35% (n = 13) at 6 months, 36% at 12 months (n = 8), and 27% (n = 4) at 2 years postoperatively. In group 2, ECL in surviving grafts was 41% (n = 10) at 6 months, 36% (n = 9) at 12 months, and 38% (n = 8) at 2 years postoperatively. Rebubbling rate in group 1 was 18.5% (5/27) and 35.9% (14/39) in group 2 (p = 0.079). Conclusion Eyes with previous GDD had no higher risk for an increased rebubbling rate but a higher risk for a re-DMEK due to secondary graft failure with a mean transplant survival time of about 2 years. Compared to eyes with preexisting glaucoma drainage device, eyes after trabeculectomy had less secondary graft failures and a longer mean graft survival rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery

Schrittenlocher

Grass

Dietlein

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…Data from [35,38,59,77,78,92,95,97,112,131–133,134 ▪▪ ,135 ▪ –137 ▪ ,138 ▪▪ ]. DALK, deep anterior lamellar keratoplasty; DMEK, Descemet's membrane endothelial keratoplasty; DSAEK, Descemet's stripping endothelial keratoplasty; HSV-1, herpes simplex virus 1; IOL, intraocular lens; PKP, penetrating keratoplasty.aIncludes bullous keratopathy, severe dry eye disease, ocular mucous membrane pemphigoid, Steven–Johnson syndrome, chemical injury.…”

Section: Understanding Rejection Riskmentioning

confidence: 99%

Impact of vaccination on keratoplasty

Dugan

2022

Current Opinion in Ophthalmology

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Purpose of reviewCorneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions.Recent findingsGraft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated with rejection. Vaccination increases circulation of proinflammatory cytokines, CD4+ and CD8+ T-cell responses, and antispike neutralizing antibody, all of which may contribute to graft rejection. Two prospective studies have found no relationship between recent vaccination and rejection but 20% of cornea specialists report to have seen a vaccine-associated rejection and 22% recommend delaying vaccination in certain circumstances. Many specialists recommend prophylactic topical corticosteroids before and after vaccination to mitigate rejection risk but there is no evidence to support this practice on a wider scale.SummaryOur framework identified 96.8% of penetrating keratoplasty patients with vaccine-associated rejection as higher risk. Further research is needed in order to develop evidence-based guidelines.

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“…Pasari et al 42 showed graft survival probability gradually decreased from 78% at 1 year to 39% at 3 years. Sorkin et al 60 investigated graft survival at 4 years based on previous studies showing a possible downward trend of graft survival over time. They found a survival drop over the third and fourth postoperative years, with cumulative 2-, 3-, and 4-year DMEK survival probability rates of 60%, 43%, and 27%, respectively.…”

Section: Dmek In Eyes With Prior Glaucoma Surgerymentioning

confidence: 99%

“…Beyond graft failure, they found a significantly high rejection rate compared to the control group (19.6% vs. 2.3%, p=0.01). 60 The baseline high inflammatory status of eyes with previous glaucoma surgery due to disruption of the blood-aqueous barrier may be one of the reasons leading to this difference. Endothelial cell loss is another important consideration in patients with prior glaucoma surgery.…”

Section: Dmek In Eyes With Prior Glaucoma Surgerymentioning

confidence: 99%

Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty

Kemer¹,

Karaca²,

Oellerich³

et al. 2021

tjo

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Endothelial keratoplasty has replaced traditional penetrating keratoplasty for the treatment of corneal endothelial dysfunction. It offers faster, more predictable, stable visual recovery and low rejection rates while the surgery itself is less invasive. Descemet membrane endothelial keratoplasty (DMEK) is currently the gold standard for the treatment of Fuchs endothelial dystrophy, bullous keratopathy, and corneal edema after cataract surgery. Its favorable long-term outcomes are increasingly reported by large study groups. This review summarizes the current literature on new DMEK techniques, including size and shape modifications, new graft delivery techniques, and surgical pearls for challenging cases like eyes with glaucoma, glaucoma tubes, and failed penetrating keratoplasties.

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Four-Year Survival of Descemet Membrane Endothelial Keratoplasty in Patients With Previous Glaucoma Surgery

Cited by 29 publications

References 21 publications

Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery

Graft survival of Descemet membrane endothelial keratoplasty (DMEK) in corneal endothelial decompensation after glaucoma surgery

Impact of vaccination on keratoplasty

Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty

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