Sutured Descemet Membrane Endothelial Keratoplasty in Patients With Complex Anatomy or Difficulty Positioning

Li, Gavin; Shekhawat, Nakul; Eghrari, Allen O.

doi:10.1097/ico.0000000000003202

Cited by 3 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be noted that 1 group of investigators also reported a series of 3 DMEK grafts in which full-thickness sutures were placed tangential to the graft edge. 20 The American Academy of Ophthalmology's Technology Assessment of DSEK reported graft detachment as the most common complication in a review of literature before 2011. 2 The average detachment rate among studies was 14.5%.…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that 1 group of investigators also reported a series of 3 DMEK grafts in which full-thickness sutures were placed tangential to the graft edge. 20…”

Section: Discussionmentioning

confidence: 99%

“…To this end, we are aware of reported methods using a single suture 5,[15][16][17] or an anterior chamber retention suture 18,19 to support a DSEK graft or multiple tangential sutures to fixate DMEK grafts. 20 Here, we report our technique using multiple, full-thickness, radial 11-0 nylon sutures to fixate the graft in high-risk eyes undergoing DSEK. In this group, we evaluated the primary outcome measure of graft detachment and secondary outcomes of early graft failure and 12month graft survival in comparison to high-risk DSEK without suture fixation and low-risk DSEK without suture fixation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Suture Fixation to Reduce Graft Detachment in Descemet Stripping Endothelial Keratoplasty

Witsberger,

Oyemade,

Rauen

et al. 2023

Cornea

View full text Add to dashboard Cite

Purpose: The aim of this study was to report the outcomes of graft fixation using interrupted, full-thickness sutures on graft detachment after Descemet stripping endothelial keratoplasty (DSEK). Methods: All DSEK procedures performed at Mayo Clinic, Rochester, MN, from 2015 through 2022 were retrospectively reviewed. Risk factors for graft detachment were defined as previous incisional glaucoma surgery, previous penetrating keratoplasty, or absence of the normal lens–capsule barrier. Cases were categorized into sutured, high-risk grafts; unsutured, high-risk grafts; and unsutured, low-risk grafts. The primary outcome was graft detachment, and secondary outcomes were early graft failure and graft clarity at 12 months after surgery. Results: Demographics between the high-risk groups were similar for sex and age at the time of surgery. Graft detachment occurred in 4 of 97 sutured, high-risk eyes (4.1%) and 24 of 119 unsutured high-risk eyes (20.2%) (P = 0.002). In comparison, graft detachment occurred in 18 of 181 unsutured low-risk eyes (9.9%). The incidence of early graft failure was 2.1%, 5.0%, and 3.3% and late graft failure by 12 months was 9.8%, 12.8%, and 4.2%, respectively. Conclusions: In eyes with high-risk factors for graft detachment, suture fixation of the graft in DSEK decreased graft detachment to a rate at least as low as that in low-risk eyes.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It should be noted that 1 group of investigators also reported a series of 3 DMEK grafts in which full-thickness sutures were placed tangential to the graft edge. 20…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Suture Fixation to Reduce Graft Detachment in Descemet Stripping Endothelial Keratoplasty

Witsberger,

Oyemade,

Rauen

et al. 2023

Cornea

View full text Add to dashboard Cite

show abstract

“…In both canines and humans, graft detachment is a potential complication with DSEK. In this case, nonabsorbable 10-0 Ethilon sutures were applied dorsally and ventrally to anchor the graft to the adjacent recipient stroma, a technique we have described in humans [ 8 ]. However, placement of sutures could lead to other possible complications such as epithelial cell downgrowth or focal fungal or bacterial infection, and sutures should be monitored and/or removed postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…This bubble is expected to dissolve in about two days but provides structural support until it disappears. 10-0 nylon sutures were used to fix the graft in place using a technique we have reported for human EK [ 8 ]. Subconjunctival injections of betamethasone and gentamicin were administered.…”

Section: Case Presentationmentioning

confidence: 99%

Canine Descemet Stripping Endothelial Keratoplasty with a Tissue Insertion Device: Technique and Long-Term Outcome

Chen,

Solar,

Lewis

et al. 2023

Case Reports in Veterinary Medicine

Self Cite

View full text Add to dashboard Cite

Introduction. We describe a case of canine Descemet’s stripping endothelial keratoplasty (DSEK) using an open-source canine tissue delivery device. Case Presentation. We follow the four-year outcomes of a 1.5-year-old Tibetan Terrier who presented with difficulty seeing, diffuse corneal edema, and central corneal thickness of 1400 microns in the left eye. To perform DSEK, a polycarbonate carrier and insertion device was designed for canine corneas that measure up to 15 mm in diameter. The tissue was loaded into the inserter prior to surgery with the endothelium facing inwards and the stroma facing the cartridge wall. From the cartridge, the graft was pulled into the eye using microforceps and an anterior chamber maintainer. We assessed preoperative endothelial cell count, postoperative corneal clearance, and graft adhesion. The donor was a two-year-old Airedale Terrier who died one day prior to surgery, with endothelial cell density of 3149 cells/mm2. One week after DSEK, the cornea began to clear, and pachymetry of the donor and graft total was 1410 microns. This improved to 800 microns at 4 months and continued improving in its clarity at the last postoperative visit 4 years after surgery. Discussion. We demonstrate the feasibility of conducting canine endothelial keratoplasty with a specially designed tissue delivery device and the potential of long-term corneal clearance after DSEK in canine eyes.

show abstract

Descemet Membrane Endothelial Keratoplasty in Aphakic, Aniridic, and Vitrectomized Eyes: A Review

Romano,

Shimizu,

Kobayashi

et al. 2024

Cornea

View full text Add to dashboard Cite

Purpose: The aim of this review is to examine the techniques, complications, and outcomes of Descemet membrane endothelial keratoplasty (DMEK) in aphakic, aniridic, and vitrectomized eyes. Methods: A literature search was conducted in the MEDLINE database (via PubMed), using as keywords “(DMEK) AND (aphakia OR aniridia OR vitrectomy OR vitrectomized).” The research was limited to 10 years (January 2014–March 2024), in view of lack of literature before 2014. Articles, including case reports and case series, were included. Results: Twenty articles were included. No randomized controlled trials were found nor comparative studies with more than 1 technique used. Mean rebubbling rate in complex eyes was 29%, whereas mean endothelial cell loss at 6 months was 37%. The mean postoperative visual acuity improved from 1.47 logarithm of the minimal angle of resolution to 0.7 logarithm of the minimal angle of resolution. Conclusions: Despite being more challenging, compared with the techniques reported in literature, DMEK can be considered a valid option for the management of endothelial decompensation in complex eyes, with rebubbling rate and endothelial cell loss at 6 months, which are similar to non-complex eyes.

show abstract

Sutured Descemet Membrane Endothelial Keratoplasty in Patients With Complex Anatomy or Difficulty Positioning

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 3 publications

References 18 publications

Suture Fixation to Reduce Graft Detachment in Descemet Stripping Endothelial Keratoplasty

Suture Fixation to Reduce Graft Detachment in Descemet Stripping Endothelial Keratoplasty

Canine Descemet Stripping Endothelial Keratoplasty with a Tissue Insertion Device: Technique and Long-Term Outcome

Descemet Membrane Endothelial Keratoplasty in Aphakic, Aniridic, and Vitrectomized Eyes: A Review

Contact Info

Product

Resources

About