Influence of air tamponade time on graft adherence after Descemet's membrane endothelial keratoplasty

Session Details

Session Title: Cornea
Session Date/Time: Friday 10/02/2017 | 08:30-10:00
Paper Time: 09:30
Venue: Brussels Room 0.4

First Author: L.Ham THE NETHERLANDS
Co Author(s): J. Peraza-Nieves  L. Baydoun   T. Muller  I. Dapena  G. Melles     

Abstract Details

Purpose:

To compare clinical outcomes at 1 month using postoperative air tamponade durations of 60 vs. 45 vs. 30 minutes after Descemet membrane endothelial keratoplasty (DMEK) in eyes with uncomplicated Fuchsﾒ endothelial dystrophy (FED).

Setting:

Netherlands Institute for Innovative Ocular Surgery / tertiary referral center

Methods:

In this randomized, prospective, comparative, interventional case series, 30 eyes of 30 patients with FED that underwent DMEK using a postoperative air tamponade duration of 60 (group 1) vs. 45 (group 2) vs. 30 minutes (group 3) were evaluated, with 10 eyes in each group. At 1 month after surgery, graft attachment status, best corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications were recorded

Results:

One month after surgery, no clinically significant detachment was reported. Minor detachment (< 1/3 of graft size) was observed in 1 eye in group 2 and 3 (3.3% each) and in 2 eyes in group 1 (6.7%). No secondary interventions were required and no episodes of primary graft failure were documented. BCVA improved in all eyes. Mean ECD decline in all eyes was 40ﾱ15%. Mean preoperative pachymetry was 682ﾱ103ﾵm vs. 515ﾱ48ﾵm postoperatively (mean decrease of 23%). No significant differences were observed for any of the parameters between the groups.

Conclusions:

Clinical outcomes at 1 month after DMEK were similar in all 3 groups with no significant graft detachments. These results may suggest that a reduction of postoperative air tamponade time from 60 to 45 or even 30 minutes may be a safe option for DMEK in eyes with uncomplicated FED.

Financial Disclosure:

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