Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty
Purpose Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our fi...
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| Veröffentlicht in: | Graefe's archive for clinical and experimental ophthalmology 2017-05, Vol.255 (5), p.979-985 |
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| creator | Heinzelmann, Sonja Böhringer, Daniel Eberwein, Philipp Lapp, Thabo Reinhard, Thomas Maier, Philip |
| description | Purpose
Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our first clinical results.
Methods
Nineteen eyes with endothelial graft failure following PK were treated with DMEK. The majority of these eyes (12) had limited visual potential. The major indication for DMEK was pain relief in patients with bullous keratopathy. Visual acuity (VA), central corneal thickness (CCT), rate of graft dislocations, graft survival, graft rejections and other complications were extracted from the medical records.
Results
Although comorbidities limiting VA were present in 12 of the 19 eyes, VA increased from 0.05 to 0.1 (median) in 16 eyes. CCT decreased substantially (range 63–363 μm). Rebubbling was necessary in five eyes with incomplete graft adherence. There were two immunologic graft reactions and three graft failures. No major complications like endophthalmitis or expulsive bleeding occurred.
Conclusions
DMEK is feasible to treat endothelial graft failure following PK. This is even true for eyes with limited visual potential. |
| doi_str_mv | 10.1007/s00417-017-3600-6 |
| format | Article |
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Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our first clinical results.
Methods
Nineteen eyes with endothelial graft failure following PK were treated with DMEK. The majority of these eyes (12) had limited visual potential. The major indication for DMEK was pain relief in patients with bullous keratopathy. Visual acuity (VA), central corneal thickness (CCT), rate of graft dislocations, graft survival, graft rejections and other complications were extracted from the medical records.
Results
Although comorbidities limiting VA were present in 12 of the 19 eyes, VA increased from 0.05 to 0.1 (median) in 16 eyes. CCT decreased substantially (range 63–363 μm). Rebubbling was necessary in five eyes with incomplete graft adherence. There were two immunologic graft reactions and three graft failures. No major complications like endophthalmitis or expulsive bleeding occurred.
Conclusions
DMEK is feasible to treat endothelial graft failure following PK. This is even true for eyes with limited visual potential.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-017-3600-6</identifier><identifier>PMID: 28160068</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cornea ; Corneal Diseases - surgery ; Descemet Stripping Endothelial Keratoplasty - methods ; Endothelium, Corneal - pathology ; Feasibility Studies ; Female ; Follow-Up Studies ; Graft Rejection - surgery ; Graft Survival ; Humans ; Keratoplasty, Penetrating - adverse effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Ophthalmology ; Retrospective Studies ; Time Factors ; Visual Acuity</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2017-05, Vol.255 (5), p.979-985</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>Graefe's Archive for Clinical and Experimental Ophthalmology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-de8899d0d0cf08545d7c2ebe93223202f18e27b048c52b1361b74f6891562ac53</citedby><cites>FETCH-LOGICAL-c372t-de8899d0d0cf08545d7c2ebe93223202f18e27b048c52b1361b74f6891562ac53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00417-017-3600-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00417-017-3600-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28160068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heinzelmann, Sonja</creatorcontrib><creatorcontrib>Böhringer, Daniel</creatorcontrib><creatorcontrib>Eberwein, Philipp</creatorcontrib><creatorcontrib>Lapp, Thabo</creatorcontrib><creatorcontrib>Reinhard, Thomas</creatorcontrib><creatorcontrib>Maier, Philip</creatorcontrib><title>Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>Purpose
Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our first clinical results.
Methods
Nineteen eyes with endothelial graft failure following PK were treated with DMEK. The majority of these eyes (12) had limited visual potential. The major indication for DMEK was pain relief in patients with bullous keratopathy. Visual acuity (VA), central corneal thickness (CCT), rate of graft dislocations, graft survival, graft rejections and other complications were extracted from the medical records.
Results
Although comorbidities limiting VA were present in 12 of the 19 eyes, VA increased from 0.05 to 0.1 (median) in 16 eyes. CCT decreased substantially (range 63–363 μm). Rebubbling was necessary in five eyes with incomplete graft adherence. There were two immunologic graft reactions and three graft failures. No major complications like endophthalmitis or expulsive bleeding occurred.
Conclusions
DMEK is feasible to treat endothelial graft failure following PK. This is even true for eyes with limited visual potential.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cornea</subject><subject>Corneal Diseases - surgery</subject><subject>Descemet Stripping Endothelial Keratoplasty - methods</subject><subject>Endothelium, Corneal - pathology</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Rejection - surgery</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Keratoplasty, Penetrating - adverse effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Visual Acuity</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kF9LwzAUxYMobk4_gC9S8MWX6k3SpNmjzL8w8EVhbyFtb2dn2s6kRfbtzeiUIRgICTe_c3LvIeScwjUFSG88QELTGMLmEiCWB2RMEy7iFNjikIwhZTRWnC1G5MT7FQScC3pMRkzRwEs1JvoOfY41dlGNdeZMgxE2Rdu9o62MjT7Qma5dW-O7TVS2Llo6U3ZRaSrbOwwVa9uvqllGa2ywC-z2vi86JUelsR7PdueEvD3cv86e4vnL4_Psdh7nPGVdXKBS02kBBeQlKJGIIs0ZZjjljHEGrKQKWZpBonLBMsolzdKklGpKhWQmF3xCrgbftWs_e_SdrqswmLVhorb3miopBFNKbNHLP-iq7V0TugtUWFIpgEDRgcpd673DUq9dVRu30RT0Nn09pK9D-nqbvpZBc7Fz7rMai1_FT9wBYAPgw1OzRLf39b-u30CykC8</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Heinzelmann, Sonja</creator><creator>Böhringer, Daniel</creator><creator>Eberwein, Philipp</creator><creator>Lapp, Thabo</creator><creator>Reinhard, Thomas</creator><creator>Maier, Philip</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty</title><author>Heinzelmann, Sonja ; Böhringer, Daniel ; Eberwein, Philipp ; Lapp, Thabo ; Reinhard, Thomas ; Maier, Philip</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-de8899d0d0cf08545d7c2ebe93223202f18e27b048c52b1361b74f6891562ac53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cornea</topic><topic>Corneal Diseases - surgery</topic><topic>Descemet Stripping Endothelial Keratoplasty - methods</topic><topic>Endothelium, Corneal - pathology</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Rejection - surgery</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Keratoplasty, Penetrating - adverse effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heinzelmann, Sonja</creatorcontrib><creatorcontrib>Böhringer, Daniel</creatorcontrib><creatorcontrib>Eberwein, Philipp</creatorcontrib><creatorcontrib>Lapp, Thabo</creatorcontrib><creatorcontrib>Reinhard, Thomas</creatorcontrib><creatorcontrib>Maier, Philip</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heinzelmann, Sonja</au><au>Böhringer, Daniel</au><au>Eberwein, Philipp</au><au>Lapp, Thabo</au><au>Reinhard, Thomas</au><au>Maier, Philip</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><stitle>Graefes Arch Clin Exp Ophthalmol</stitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>255</volume><issue>5</issue><spage>979</spage><epage>985</epage><pages>979-985</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>Purpose
Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our first clinical results.
Methods
Nineteen eyes with endothelial graft failure following PK were treated with DMEK. The majority of these eyes (12) had limited visual potential. The major indication for DMEK was pain relief in patients with bullous keratopathy. Visual acuity (VA), central corneal thickness (CCT), rate of graft dislocations, graft survival, graft rejections and other complications were extracted from the medical records.
Results
Although comorbidities limiting VA were present in 12 of the 19 eyes, VA increased from 0.05 to 0.1 (median) in 16 eyes. CCT decreased substantially (range 63–363 μm). Rebubbling was necessary in five eyes with incomplete graft adherence. There were two immunologic graft reactions and three graft failures. No major complications like endophthalmitis or expulsive bleeding occurred.
Conclusions
DMEK is feasible to treat endothelial graft failure following PK. This is even true for eyes with limited visual potential.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28160068</pmid><doi>10.1007/s00417-017-3600-6</doi><tpages>7</tpages></addata></record> |
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| ispartof | Graefe's archive for clinical and experimental ophthalmology, 2017-05, Vol.255 (5), p.979-985 |
| issn | 0721-832X 1435-702X |
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| source | MEDLINE; SpringerLink |
| subjects | Adult Aged Aged, 80 and over Cornea Corneal Diseases - surgery Descemet Stripping Endothelial Keratoplasty - methods Endothelium, Corneal - pathology Feasibility Studies Female Follow-Up Studies Graft Rejection - surgery Graft Survival Humans Keratoplasty, Penetrating - adverse effects Male Medicine Medicine & Public Health Middle Aged Ophthalmology Retrospective Studies Time Factors Visual Acuity |
| title | Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty |
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