Posters

Guttae-like changes post DMEK: a case series

Poster Details

First Author: P.VIola ITALY

Co Author(s): E. Neri   R. Cian   A. Iovieno   S. Soldati           

Abstract Details

Purpose:

to analyze and discuss the incidence and outcome of guttae-like changes post Descemet Membrane Endothelial Keratoplasty (DMEK) in patients affected by Fuchs’ dystrophy.

Setting:

San Bortolo Hospital, Vicenza (Italy). All surgeries were performed by the one surgeon (PV)

Methods:

retrospective case series of who underwent DMEK (Parekh-Busin technique) for Fuchs dystrophy. All donor corneas were deemed suitable for endothelial keratoplasty and did not present central or peripheral guttae preoperatively. Mean follow-up time was 19.75 ± 11.15 (range: 12-36) months. Corrected distance visual acuity (CDVA), high magnification clinical pictures, endothelial cell count (ECC), endothelial cell loss (ECL), central corneal thickness (CCT) and in-vivo confocal microscopy (IVCM) images were obtained. Last follow-up data are reported.

Results:

guttae-like-changes were found in 3 patients/4 eyes (4/118 DMEK,3.39%) since their 1st month visit. Patient-1 with bilateral DMEK developed guttae in the left eye only (CDVA 20/20, ECC 1598cells/mm2,ECL 36%,CCT 495mm). IVCM was within normal limits. Patient-2 developed bilateral guttae (Right eye: CDVA 20/20,ECC 1506 cells/mm2,ECL 42%,CCT 594mm; left eye: CDVA 20/20,ECC 1509cells/mm2,ECL 39%,CCT 569mm). Both eyes had guttae-like-figures at IVCM. Increased guttae and endothelial cell decay were detected in the left eye over time. Similar changes were observed in Patient-3’s left eye after bilateral DMEK (CDVA 20/20, ECC 680cells/mm2,ECL 72%,CCT 478mm). IVCM wasn't performed.

Conclusions:

Guttae-like changes can be detected in 3% of post-DMEK patients. These changes are often benign, although endothelial decay can be observed. Pathogenesis is presently uncertain.

Financial Disclosure:

None