Intraocular Pressure Measurements After Descemet Membrane Endothelial Keratoplasty

Maier, Anna-Karina B.; Gundlach, Enken; Pahlitzsch, Milena; Gonnermann, Johannes; Corkhill, Caitlin; Bertelmann, Eckart; Joussen, Antonia M.; Klamann, Matthias K. J.; Torun, Necip

doi:10.1097/ijg.0000000000000593

Cited by 16 publications

(26 citation statements)

References 53 publications

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“…This proportion is comparable with previous reports with IOP elevation after DMEK or Descemet stripping automated endothelial keratoplasty ranging from 0% to 15.4%. 10,17,19,28,30,31 Patient populations and definitions of elevated IOP vary considerably between studies and include thresholds ranging from 21 to 30 mm Hg and/or a threshold of 10 mm Hg above preoperative baseline values. 10,17,19,28,30,31 In our study, decimal BCVA increased, whereas CCT and ECC decreased significantly from preoperative values in patients without (group A) and with (group B) IOP elevation and there was no evidence for postoperative differences between both groups over a 6-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Impact of Early Intraocular Pressure Elevation on Postoperative Outcomes After Descemet Membrane Endothelial Keratoplasty in Non-glaucoma Patients

Lentzsch

Adler

Siebelmann

et al. 2021

Cornea

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The purpose of this study was to investigate the impact of transient elevations in postoperative intraocular pressure (IOP) on the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) surgery in non-glaucoma patients.Methods: Retrospective analysis from a prospective database of eyes without preexisting glaucoma that underwent DMEK with 90% anterior chamber and 20% sulfur hexafluoride endotamponade. Group A included eyes without postoperative IOP increase (IOP ,30 mm Hg and a relative increase from preoperative value ,10 mm Hg). Group B included eyes with IOP elevation (postoperative IOP $30 mm Hg or a relative increase from preoperative value $10 mm Hg) handled according to a standardized protocol. The impact of elevated IOP within 3 days after DMEK surgery was evaluated regarding best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) at 1, 3, and 6 months.Results: One hundred seventy-six eyes from 164 patients were included. An IOP increase after DMEK occurred in 20 eyes (11.3%; 19 patients, group B), and the mean peak IOP was 48 6 12 mm Hg (range 32-69 mm Hg). There were no significant postoperative differences in BCVA, CCT, and ECC on comparing both groups. The BCVA increased significantly (P , 0.001, respectively), whereas CCT (P , 0.001, respectively) and ECC (P , 0.001, respectively) decreased significantly from preoperative values. The rebubbling rate tended to be higher in group B without statistical significance (6.4% vs. 10%, P = 0.648). Conclusions:Temporary IOP elevation after DMEK may not affect functional and morphological outcomes in non-glaucoma patients. However, careful postoperative IOP monitoring and appropriate management are crucial to avoid irreversible ocular damage.

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Section: Discussionmentioning

confidence: 99%

Impact of Early Intraocular Pressure Elevation on Postoperative Outcomes After Descemet Membrane Endothelial Keratoplasty in Non-glaucoma Patients

Lentzsch

Adler

Siebelmann

et al. 2021

Cornea

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“…33,36 Maier et al reported a signi cant correlation between non-contact tonometer (NCT), iCare, and CT at months 1 and 3 postoperatively in DMEK patients, but there was no correlation between CT, GAT, and Dynamic Contour Tonometry (DCT). 10 These results may indicate that the correlation depends on the type of IOP measurement device. Hugo et al claimed that the CT measurements were less reliable after lamellar keratoplasty due to interfaces and changes in the corneal shape.…”

Section: Discussionmentioning

confidence: 93%

WITHDRAWN: Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

Gümüş¹,

Altan

Yıldırım

et al. 2021

Preprint

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Purpose To evaluate early intraocular pressure (IOP) changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD) and IOP changes. Methods We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results Twenty-two patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and 6 hours postoperatively and between the IOP preoperatively and 24 hours postoperatively were statistically significant in the three types of surgery (p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (p = 0.021). There was no correlation between ACD, corneal thickness, K values, and IOP in any group. Conclusion IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

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“… 5 The rate of IOP increase after PK is higher than after lamellar keratoplasties. 3 Different studies have shown variable incidences of elevated IOP after different keratoplasty techniques as follows: 9–37% following PK; 5 – 8 6.5–24% following DMEK; 9 – 11 and 1.3–36.1% following DALK. 12 – 14 This study aimed to provide new insight into the early changes in IOP in three different corneal transplantation surgeries (PK, DALK, and DMEK) and the effect of corneal parameters and ACD on IOP changes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the increased CT did not falsely elevate the IOP, which was measured using GAT both post-DSEK 24 , 32 , 33 and post-DALK. 31 , 34 Maier et al 9 reported a significant correlation between non-contact tonometer (NCT), iCare, and CT at months 1 and 3 postoperatively in DMEK patients, but there was no correlation between CT, GAT, and Dynamic Contour Tonometry (DCT). These results may indicate that the correlation depends on the type of IOP measurement device.…”

Section: Discussionmentioning

confidence: 99%

Early intraocular pressure changes following different keratoplasty techniques and association with cornea parameters and anterior chamber depth

et al. 2022

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Background: Corneal transplantation surgery is associated with an increased risk of intraocular pressure (IOP) elevation. Increased IOP may cause irreversible vision loss and graft failure.Purpose: We aimed to evaluate early IOP changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD), and IOP changes. Methods: We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and Descemet membrane endothelial keratoplasty (DMEK) in this observational study. ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results: In total, 22 patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and postoperatively hour 6, and between the IOP preoperatively and postoperatively hour 24 was statistically significant in the three types of surgery ( p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group ( p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups ( p = 0.021). There was no correlation between ACD, CT, K values, and IOP in any group. Conclusion: IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

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Intraocular Pressure Measurements After Descemet Membrane Endothelial Keratoplasty

Cited by 16 publications

References 53 publications

Impact of Early Intraocular Pressure Elevation on Postoperative Outcomes After Descemet Membrane Endothelial Keratoplasty in Non-glaucoma Patients

Impact of Early Intraocular Pressure Elevation on Postoperative Outcomes After Descemet Membrane Endothelial Keratoplasty in Non-glaucoma Patients

WITHDRAWN: Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

Early intraocular pressure changes following different keratoplasty techniques and association with cornea parameters and anterior chamber depth

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