Cornea · 2024
Off-Centered Descemet Membrane Endothelial Keratoplasty Grafts: Impact and Resolution.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Romano Vito, Airaldi Matteo, Romano Davide, Miglio Francesco, Borgia Alfredo, Parekh Mohit, Semeraro Francesco, Pereira Nicolas Cesário
Аннотация
PURPOSE: The aim of this study was to assess the outcomes of off-centered Descemet membrane endothelial keratoplasty (DMEK) grafts compared to descemetorhexis.
METHODS: This is a retrospective case series of DMEK procedures conducted between June 2022 and July 2023 with postoperative graft decentration, characterized by a gap between the graft and descemetorhexis edge.
RESULTS: Eight eyes of 8 patients met the inclusion criteria. The average gap between the descemetorhexis edge and DMEK graft was 911.2 μm (range 306-1468). The resulting focal peripheral edema overlying the gap resolved in all cases, with a median time of 3 months. Best-corrected visual acuity improved from 0.49 (±0.26) logarithm of the minimum angle of resolution to 0.01 (±0.02) logarithm of the minimum angle of resolution at 12 months ( P = 0.003). Central corneal thickness decreased from 646.5 (±177.8) μm to 473.7 (±29.6) μm at 12 months ( P = 0.05). One eye, in the overlapped area of host-donor Descemet membranes, had small peripheral partial graft detachment less than one-third of graft surface area. No eyes required graft rebubbling. A larger descemetorhexis to DMEK gap showed a trend toward longer resolution times ( P = 0.06). Focal edema in the inferonasal periphery took longer to recover compared with the nasal position ( P = 0.01). Larger descemetorhexis to DMEK gaps did not significantly influence the longitudinal visual acuity trend ( P = 0.75).
CONCLUSIONS: Decentered DMEK, characterized by a gap between the graft and descemetorhexis edge, leads to focal stromal edema that diminishes over time, with no impact on final visual acuity.
METHODS: This is a retrospective case series of DMEK procedures conducted between June 2022 and July 2023 with postoperative graft decentration, characterized by a gap between the graft and descemetorhexis edge.
RESULTS: Eight eyes of 8 patients met the inclusion criteria. The average gap between the descemetorhexis edge and DMEK graft was 911.2 μm (range 306-1468). The resulting focal peripheral edema overlying the gap resolved in all cases, with a median time of 3 months. Best-corrected visual acuity improved from 0.49 (±0.26) logarithm of the minimum angle of resolution to 0.01 (±0.02) logarithm of the minimum angle of resolution at 12 months ( P = 0.003). Central corneal thickness decreased from 646.5 (±177.8) μm to 473.7 (±29.6) μm at 12 months ( P = 0.05). One eye, in the overlapped area of host-donor Descemet membranes, had small peripheral partial graft detachment less than one-third of graft surface area. No eyes required graft rebubbling. A larger descemetorhexis to DMEK gap showed a trend toward longer resolution times ( P = 0.06). Focal edema in the inferonasal periphery took longer to recover compared with the nasal position ( P = 0.01). Larger descemetorhexis to DMEK gaps did not significantly influence the longitudinal visual acuity trend ( P = 0.75).
CONCLUSIONS: Decentered DMEK, characterized by a gap between the graft and descemetorhexis edge, leads to focal stromal edema that diminishes over time, with no impact on final visual acuity.