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Management and clinical outcome of post-DMEK keratitis

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First Author: B.Tanyildiz TURKEY

Co Author(s):    N. Günaydın   B. Kandemir                 

Abstract Details

Purpose:

To study the outcome of patients with post-DMEK keratitis treated at a single institution.

Setting:

We reviewed the records of patients with post-DMEK keratitis during the period 2016-2019.

Methods:

Data were reviewed to obtain demographic characteristics, details of microbial keratitis, graft survival and clinical outcomes.

Results:

A total of 9 patients were identified. Their mean age was 70.4±7.4 years. The mean follow-up period was 19.0±8.2 months. Indications for DMEK were: Pseudophakic bullous keratopathy (n=4); irreversible corneal edema due to endotheliitis (n=3); Fuchs’ endothelial dystrophy (n=1), failed previous DMEK (n=1).Corneal pachymetry significantly decreased from 762±67 µm at day 1 to 667± 114 µm at 6 months (P=0.4). Postoperative complications in patients included persistent corneal epithelial defect in nine eyes (100%), recurrent endotheliitis in three eyes (33%), and graft detachment in three eyes (33%). Nine patients of 6 (66.6%) were culture positive including Aspergillus (2), Candida (2), P. aeruginosa (1), S. epidermidis (1). Two of 9 eyes had recurrence herpetic keratouvetis. One of them was culture negative. Keratitis was successfully treated in two eyes (22.2%). Penetrating keratoplasty was performed in three eyes (33.3%) and graft failure was seen in four eyes (44.4%).

Conclusions:

The use of topical steroids and bandage contact lenses are thought to be the predisposing factor in keratitis after DMEK. Persistent epithelial defects that develop after surgery are the most important factor in the development of post-DMEK keratitis.

Financial Disclosure:

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