BMC ophthalmology · 2025
Graft-repositioning technique using infusion and small bubbles during Descemet's membrane endothelial keratoplasty.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shimizu Toshiki, Oyakawa Itaru, Tomida Daisuke, Yokogawa Hideaki, Kobayashi Akira, Yamagami Satoru, Hayashi Takahiko
Аннотация
BACKGROUND: Descemet's membrane endothelial keratoplasty (DMEK) is a highly effective procedure for corneal endothelial dysfunction; however, once a DMEK graft is deployed, repositioning can be challenging. Therefore, this study aimed to evaluate the efficacy of a technique that utilizes infusion and small air bubbles to reposition a misaligned deployed graft.
METHODS: This retrospective interventional case series enrolled patients who underwent DMEK between January 2022 and July 2023, including cases where the DMEK graft was attached and unfolded in off-center positions". Experienced surgeons performed DMEK by inserting an infusion cannula and positioning a small bubble in the anterior chamber after the graft unfolded off-center. The eye was tilted in a deviated direction, and the cornea was massaged from the corneal limbus to the center using a 27-gauge blunt needle. Before and after DMEK, we measured the best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD). Additionally, we monitored the incidence of postoperative complications.
RESULTS: Six eyes of six patients were included in this study. Postoperatively, the overall BSCVA and CCT of the eyes improved (P < 0.001). However, one eye developed recurrent uveitis and required a sub-Tenon's capsule triamcinolone acetonide injection. No eyes required re-bubbling, and no instances of primary graft failure were observed.
CONCLUSION: The described technique enables the safe and feasible repositioning and unfolding of the DMEK graft.
METHODS: This retrospective interventional case series enrolled patients who underwent DMEK between January 2022 and July 2023, including cases where the DMEK graft was attached and unfolded in off-center positions". Experienced surgeons performed DMEK by inserting an infusion cannula and positioning a small bubble in the anterior chamber after the graft unfolded off-center. The eye was tilted in a deviated direction, and the cornea was massaged from the corneal limbus to the center using a 27-gauge blunt needle. Before and after DMEK, we measured the best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD). Additionally, we monitored the incidence of postoperative complications.
RESULTS: Six eyes of six patients were included in this study. Postoperatively, the overall BSCVA and CCT of the eyes improved (P < 0.001). However, one eye developed recurrent uveitis and required a sub-Tenon's capsule triamcinolone acetonide injection. No eyes required re-bubbling, and no instances of primary graft failure were observed.
CONCLUSION: The described technique enables the safe and feasible repositioning and unfolding of the DMEK graft.