Posters

Pre-Descemet’s endothelial keratoplasty (PDEK): learning curve in the first Brazilian cases

Poster Details

First Author: E. Torres Netto BRAZIL

Co Author(s):    M. Rivera-Monge   D. Freitas   A. Moriyama              

Abstract Details

Purpose:

To describe learning curve of Pre descemet endothelial keratoplasty (PDEK) and intraoperatory findings of the first 5 Brazilian cases, performed at Federal University of Sao Paulo.

Setting:

In countries like Brazil, where there are no pre-prepared tissue for keratoplasty, younger corneas, which currently are not selected to DMEK, could be used. Therefore, the dissemination of this technique may have high impact, since it could increase the amount of endothelial transplantation.

Methods:

Five PDEK procedures were performed by the same surgeon; four cases using pneumodissection and one case reverse hydro-bubble to obtain the donor graft. All cases were recorded, and the following intraoperative variables were measured: type of bubble obtained, button size used and time of opening and centralization of the graft.

Results:

Type-1 Big Bubble (BB) was achieved in three of the cases where air dissection was used. In the fourth case of pneumodissection, there was simultaneous formation of type-1 and type-2 BB. When balanced salt solution was used for dissection, type-2 BB was obtained. Every time type-2 BB was formed, the procedure was converted to Descemet membrane endothelial keratoplasty (DMEK). Where the PDEK uneventful, and type-1 BB was achieved, the manipulation of the tissue was easier and its opening in the anterior chamber was quicker and without difficulty owing to the fact that it rolled less. The graft size used varied from 7.50 to 7.75mm.

Conclusions:

PDEK is a new technique of endothelial keratoplasty with some potential advantages. Early outcomes suggest potential advantages in the learning curve over the prior procedures. Long-term studies are necessary to place PDEK in corneal endothelial keratoplasty but it seems to be a technique with promising results.

Financial Disclosure:

NONE