Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Predictors of graft survival after descemet membrane endothelial keratoplasty in eyes with severe corneal edema.
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.
Gul Olke Kubra, Ozmen Mehmet Cuneyt, Ulas Berkay, Ozdemir Zeydanli Ece, Eristi Boluk Ceyda, Tefon Aribas Atike Burcin, Cetintepe Sultan Pinar, Cetintepe Sultan Pinar, Atalay Hatice Tuba, Aydin Bahri, Akata Fikret
Аннотация
PURPOSE: To identify predictors of graft survival after Descemet membrane endothelial keratoplasty (DMEK) in eyes with severe corneal edema, with particular emphasis on modifiable intraoperative factors.
METHODS: This retrospective cohort study included 112 consecutive eyes undergoing DMEK between 2014 and 2024 with at least 12 months of follow-up and available intraoperative videos. Donor, recipient, preoperative, and perioperative variables were reviewed, and intraoperative timings, including the duration of complete unfolding, were quantified from surgical recordings. Logistic regression was used to identify predictors of graft failure. Receiver operating characteristic analysis determined the optimal threshold, and graft survival was assessed using Kaplan-Meier and Cox regression analyses.
RESULTS: Graft failure developed in 24/112 eyes (21.4%) after a mean of 14.5 ± 16.1 months. The duration of complete unfolding was longer in eyes that developed graft failure (median 12.0 vs. 8.0 min; p = 0.034) and emerged as the only independent predictor in multivariable analysis (adjusted OR 1.11, 95% CI 1.01-1.21; p = 0.029). An unfolding time > 11 min showed moderate discrimination for graft failure (AUC 0.654, 95% CI 0.550-0.748; p = 0.045) and was associated with poorer graft survival (HR 3.24, 95% CI 1.45-7.24; p = 0.004).
CONCLUSIONS: In eyes with severe corneal edema undergoing DMEK, prolonged complete unfolding time was the only independent predictor of graft failure. Eyes with prolonged or difficult unfolding may merit closer postoperative follow-up.
METHODS: This retrospective cohort study included 112 consecutive eyes undergoing DMEK between 2014 and 2024 with at least 12 months of follow-up and available intraoperative videos. Donor, recipient, preoperative, and perioperative variables were reviewed, and intraoperative timings, including the duration of complete unfolding, were quantified from surgical recordings. Logistic regression was used to identify predictors of graft failure. Receiver operating characteristic analysis determined the optimal threshold, and graft survival was assessed using Kaplan-Meier and Cox regression analyses.
RESULTS: Graft failure developed in 24/112 eyes (21.4%) after a mean of 14.5 ± 16.1 months. The duration of complete unfolding was longer in eyes that developed graft failure (median 12.0 vs. 8.0 min; p = 0.034) and emerged as the only independent predictor in multivariable analysis (adjusted OR 1.11, 95% CI 1.01-1.21; p = 0.029). An unfolding time > 11 min showed moderate discrimination for graft failure (AUC 0.654, 95% CI 0.550-0.748; p = 0.045) and was associated with poorer graft survival (HR 3.24, 95% CI 1.45-7.24; p = 0.004).
CONCLUSIONS: In eyes with severe corneal edema undergoing DMEK, prolonged complete unfolding time was the only independent predictor of graft failure. Eyes with prolonged or difficult unfolding may merit closer postoperative follow-up.