Postmortem evaluation of wound healing after Descemet's membrane endothelial keratoplasty (DMEK)

Session Details

Session Title: Cornea
Session Date/Time: Friday 09/02/2018 | 08:30-10:00
Paper Time: 08:42
Venue: Annex A

First Author: T.Müller SWITZERLAND
Co Author(s): I. Lavy  R. Verdijk  M. Bruinsma  J. Parker  P. Binder  G. Melles  

Abstract Details

Purpose:

To describe the histologic features of postmortem eyes after Descemet membrane endothelial keratoplasty (DMEK) and their potential clinical implications

Setting:

Netherlands Institute of Innovativ Ocular Surgery (NIIOS), Rotterdam, The Netherlands

Methods:

Eleven postmortem corneas of eight patients, who underwent DMEK surgery for Fuchs endothelial dystrophy with an average postoperative time of 4 ± 1.9 years were procured after death and processed for light microscopy evaluation.

Results:

Nine eyes showed a ‘normal’ anatomy in the corneal center. One eye had an anatomically 'normal' periphery, ten showed peripheral abnormalities: in nine, the DMEK-graft overlapped with the host edge of the descemetorhexis; one eye showed a acellular scarring overlying a portion of the DMEK-graft that was detached followed by spontaneously adherence; three eyes showed graft folds with scar-tissue anteriorly; in two eyes (same patient), the anterior banded layer of the host DM was still in-situ across the cornea (both required re-bubbling); and two eyes showed host DM-remnants within the corneo-limbal tunnel incision that may have interfered with wound healing.

Conclusions:

Incomplete host DM removal may relate to postoperative DMEK graft detachment and wound instability. Graft detachments may re-attach with interface scarring. Re-bubbling procedures may be performed within 4-6 weeks, before scarring of detached graft portions occurs.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented