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The Cologne rebubbling study: an analysis of 624 rebubblings after Descemet's membrane endothelial keratoplasty (DMEK)

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First Author: S.Siebelmann GERMANY

Co Author(s):    K. Kolb   M. Matthaei   T. Hayashi   J. Güell   B. Bachmann   C. Cursiefen     

Abstract Details

Purpose:

To analyze graft detachments after Descemet Membrane Endothelial Keratoplasty (DMEK) before rebubbling, the influence of rebubblings on the postoperative outcome after DMEK as well as the probability of a rebubbling of the fellow eye after previous rebubbling on the first eye.

Setting:

University Hospital of Cologne, Department for Ophthalmology, Cologne, Germany.

Methods:

This is a retrospective analysis of 624 rebubblings out of 1541 DMEKs. The further analysis included 499 OCT scans and clinical pre- and postoperative data before and after rebubbling of the above mentioned DMEK patients. Graft detachments were analyzed regarding the size and localization of the postoperative detachments, as well as the influence of the total number of rebubblings on the postoperative outcome after DMEK and the probability of a rebubbling in the fellow eye after rebubbling has already become necessary.

Results:

Mean number of detachments was 2.02±0.9 per graft. Mean lateral detachment diameter was 4534.76±1920.83 microns. Mean axial diameter was 382.53±282.02 microns. Visual acuity after 12 months was 0.197±0.23 LogMAR, endothelial cell density was 1575.21±397.71 cells/mm2, central corneal thickness was 566.37±68.11 microns. Endothelial cell loss, visual acuity and corneal thickness were not influenced by the number of rebubblings or the time between DMEK and rebubbling. The rebubbled patients who later received DMEK in the other eye, 193 (58.8%) also received a rebubbling, which was significantly higher compared to the overall rebubbling rate of 32.3% (p=0.000).

Conclusions:

In the here presented study the overall number of rebubblings did not influence the postoperative outcome of the patients after DMEK, provided that rebubbling is generally necessary. The patients, where a rebubbling was already necessary in the first eye after DMEK, have an increased risk of a rebubbling in the partner eye.

Financial Disclosure:

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