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Effect of graft shift direction on graft detachment and endothelial cell survival after descemet membrane endothelial keratoplasty

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First Author: T.Hayashi JAPAN

Co Author(s):    I. Oyakawa   T. Shimizu   H. Takahashi   N. Kato   K. Yamazaki   K. Yuda     

Abstract Details

Purpose:

To investigate the effects of graft shift orientation on clinical outcomes after Descemet membrane endothelial keratoplasty (DMEK) using air injection.

Setting:

Department of Ophthalmology, Yokohama Minami Kyosai Hospital

Methods:

This study used intraoperative video images to retrospectively examine the effect of graft shift direction in 50 eyes of 50 patients. Correlations were assessed between graft shift direction and multiple parameters.

Results:

The graft detachment rate was higher in eyes with an inferior graft shift than in those without inferior graft shift (55.0 % vs 16.7 %, respectively). Postoperative endothelial cell density (ECD) reduction was higher in eyes with an inferior graft shift than those without inferior graft shift (6 months; 39.8 ± 14.9% and 50.7 ± 16.6%, respectively). Eyes with superior graft shift had lower postoperative ECD reduction than those without superior graft shift (6 months; 51.3 ± 14.6% and 35.9 ± 14.5%, respectively). Rebubbling rates were higher in eyes with an inferior graft shift orientation (p=0.017).

Conclusions:

Graft shift direction in DMEK, especially inferior graft shift, affected the postoperative graft detachment rate. Superior graft shift had a beneficial effect on postoperative corneal endothelial values. These data suggest that inferior graft shift should be avoided in DMEK.

Financial Disclosure:

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