Posters

Clinical outcome of re-bubbling for graft detachment after Descemet's membrane endothelial keratoplasty (DMEK)

Poster Details

First Author: R. Quilendrino NETHERLANDS

Co Author(s):                        

Abstract Details

Purpose:

To assess the clinical outcome after (successful) re-bubbling for visually significant graft detachment after Descemet membrane endothelial keratoplasty (DMEK).

Setting:

Netherland Institute for Innovative Ocular Surgery / tertiary referral center.

Methods:

In this retrospective analysis of 760 consecutive DMEK surgeries, 41 eyes received a re-bubbling. Main outcome measures were compared to a matched control group with uneventful primary DMEK (attached DMEK, i.e. grafts without re-bubbling). Within the study group, early versus later re-bubbling were compared. All eyes were evaluated for best-corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), anterior segment coherence tomography (AS-OCT) and complications up to 6 months after re-bubbling using multiple linear regression analyses to detect covariates and clinical outcome.

Results:

Re-bubbling was successful in 33 of 41 eyes; in three unsuccessful eyes the graft had been positioned upside-down. In eyes with successful re-bubbling, BCVA did not differ, between re-bubbled eyes and the control group at 6 months after DMEK (P>0.05). ECD decrease was significantly higher in re-bubbled eyes compared to control eyes (mean decrease: 54% versus 35%, respectively, P<0.05). CCT was similar in both groups (P>0.05). Timing of re-bubbling did not affect outcome parameters (P>0.05). No intra- or postoperative complications were observed; one buphthalmic eye showed a temporary intraocular pressure elevation.

Conclusions:

Re-bubbling for DMEK graft detachment may give visual outcomes as in uncomplicated DMEK, regardless of timing of intervention within the first 8 postoperative weeks. Re-bubbled eyes may show lower ECD, which may be attributed to additional air bubble trauma and/or more extensive manipulation during the initial DMEK (selection bias).

Financial Disclosure:

NONE