Tips, Tricks, and Guides in Descemet Membrane Endothelial Keratoplasty Learning Curve

Borroni, Davide; Lossada, C. Rocha de; Parekh, Mohit; Gadhvi, Kunal A; Bonzano, Chiara; Romano, Vito; Levis, Hannah J.; Tzamalis, Aris; Steger, Bernhard; Rechichi, Miguel; Rodríguez‐Calvo‐de‐Mora, Marina

doi:10.1155/2021/1819454

Cited by 21 publications

(18 citation statements)

References 64 publications

(69 reference statements)

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“…Additionally, long-term follow-up beyond 1-year postoperatively will help us to understand if grafts behave differently in thicker corneas. Descemet’s membrane endothelial keratoplasty (DMEK) has been introduced as an alternative to DSAEK for quicker visual recovery [ 11 , 12 ]. It would be interesting to compare DMEK and DSAEK in extremely thick recipient corneas in future studies.…”

Section: Discussionmentioning

confidence: 99%

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

Xiao

et al. 2022

JCM

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Purpose: To evaluate the outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) in corneas > 820 microns in thickness. Methods: This retrospective study included 30 eyes of 30 patients who underwent DSAEK. Endothelial cell destiny (ECD) and corneal thickness were recorded before surgery and at 1 and 12 months postoperatively. Patients were divided into two groups (≤ 820 microns and > 820 microns) based on median preoperative corneal thickness. Linear regression analyses were used to investigate the correlations between ECD and preoperative corneal thickness. Results: Recipient corneal thickness (RCT) and postoperative central cornea thickness had a statistically significant difference 1 month after surgery (p = 0.03, p = 0.08, respectively). BCVA and ECD did not have a statistical difference in the two groups at 1 month and 12 months after DSAEK. Conclusions: BCVA, ECD and corneal thickness were similar at 12 months after DSAEK in thick corneas. DSAEK is a viable surgical option in thick corneas.

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Section: Discussionmentioning

confidence: 99%

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

Xiao

et al. 2022

JCM

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“…For example, changes in the circulation patterns of aqueous humour due to the glaucoma tube have been shown to adversely affect the endothelial cell viability [ 98 – 102 ]. In addition, the glaucoma drainage device itself may induce a breach in the blood-aqueous barrier, either by intermittent tube-uveal touch and/or chronic trauma from intermittent tube-corneal touch caused by heavily rubbing the eye or forcefully blinking, resulting in an increase of influx of oxidative, apoptotic, and inflammatory proteins, potentially causing corneal endothelial damage [ 98 , 101 , 103 , 104 ].…”

Section: Glaucoma Drainage Devices (Gdds)mentioning

confidence: 99%

“…Corneal endothelial cell loss can subsequently result in corneal decompensation, and this continues to be a common comorbidity after glaucoma surgery [ 102 ]. The introduction of Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) has replaced the use of penetrating keratoplasty (PK) as the standard of care for endothelial disorders [ 103 ]. In the presence of glaucoma drainage devices, higher rates of corneal graft failure and increased ECD loss are observed after penetrating keratoplasty and DSAEK; as suggested earlier, the reasons for this are multifactorial [ 104 , 149 – 153 ].…”

Section: Descemet Membrane Endothelial Keratoplasty (Dmek) Use In The...mentioning

confidence: 99%

Corneal Endothelial Cell Loss in Glaucoma and Glaucoma Surgery and the Utility of Management with Descemet Membrane Endothelial Keratoplasty (DMEK)

Vallabh

Kennedy

Vinciguerra

et al. 2022

Journal of Ophthalmology

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The corneal endothelium has a crucial role in maintaining a clear and healthy cornea. Corneal endothelial cell loss occurs naturally with age; however, a diagnosis of glaucoma and surgical intervention for glaucoma can exacerbate a decline in cell number and impairment in morphology. In glaucoma, the mechanisms for this are not well understood, and this accelerated cell loss can result in corneal decompensation. Given the high prevalence of glaucoma worldwide, this review aims to explore the abnormalities observed in the corneal endothelium in differing glaucoma phenotypes and glaucoma therapies (medical or surgical, including with new generation microinvasive glaucoma surgeries). Descemet membrane endothelial keratoplasty (DMEK) is increasingly being used to manage corneal endothelial failure for glaucoma patients, and we aim to review the recent literature evaluating the use of this technique in this clinical scenario.

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“…Endothelial loss has been found to be correlated with severe dry eye, hypothesized to be attributed to reduced corneal nerves present both in the healthy elderly and in patients with dry eye disease [63]. If the cell decline both in number and functional capability is substantial, the corneal thickness potentially increases causing suboptimal corneal transparency [64,65]. Symptoms can include a decreased acuity and contract sensitivity or increased glare [66][67][68].…”

Section: Dry Eyementioning

confidence: 99%

Vision through Healthy Aging Eyes

Erdinest

London²,

Lavy

et al. 2021

Vision

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As life expectancy grows, so too will the number of people adversely affected by age. Although it is acknowledged that many conditions and diseases are associated with age, this mini-review will present a current update of the various visual changes that generally occur in healthy individuals disregarding the possible effects of illness. These alterations influence how the world is perceived and in turn can affect efficiency or the ability to perform ordinary daily tasks such as driving or reading. The most common physical developments include a decreased pupil size and retinal luminance as well as changes both in intercellular and intracellular connections within the retina along the pathway to the visual cortex and within the visual cortex. The quantity and the physical location of retinal cells including photoreceptors, ganglion and bipolar retinal cells are modified. The clarity of intraocular organs, such as the intraocular lens, decreases. These all result in common visual manifestations that include reduced visual acuity, dry eyes, motility changes, a contraction of the visual field, presbyopia, reduced contrast sensitivity, slow dark adaptation, recovery from glare, variation in color vision and a decreased visual processing speed. Highlighting these prevalent issues as well as current and possible future innovations will assist providers to formulate treatments and thereby conserve maximum independence and mobility in the modern mature population.

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Tips, Tricks, and Guides in Descemet Membrane Endothelial Keratoplasty Learning Curve

Cited by 21 publications

References 64 publications

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

Corneal Endothelial Cell Loss in Glaucoma and Glaucoma Surgery and the Utility of Management with Descemet Membrane Endothelial Keratoplasty (DMEK)

Vision through Healthy Aging Eyes

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