Evaluation of the use of intraoperative triamcinolone in Descemet's membrane endothelial keratoplasty

Session Details

Session Title: Cornea Surgical: Lamellar Corneal Grafts

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 09:06

Venue: Free Paper Forum: Podium 3

First Author: : J.Cabrerizo Nunez DENMARK

Co Author(s): :    I. Potapenko   M. Alberti                          

Abstract Details

Purpose:

To evaluate the effect of intraoperative triamcinolone (ITC) in the clinical results and cellular viability in Descemet Membrane Endothelial Keratoplasty (DMEK).

Setting:

Eye Clinic, Rigshospitalet. University of Copenhagen.

Methods:

Prospective clinical study, two groups DMEK+ITC (n=47) and DMEK (n=44). In the ITC group, 50 microliters of a commercially available solution of triamcinolone (40 mg/ml) are injected in the anterior chamber as the last step of the DMEK procedure, after the anterior chamber is filled with gas. Clinical outcomes, VA, re-bubble rate and endothelial cell density were evaluated up to 3 months after surgery. Graft attachment and potential postoperative complications where monitored in successive follow ups 1, 3, 7 days, 1 and 3 months after surgery. Both groups underwent standard postoperative treatment with topical dexamethasone and ketorolac.

Results:

Postoperative rebubble rate was 10 (21%) and 13 (30%) for the ITC and standard DMEK group respectively (P=0.64). Mean endothelial cell density at 3 months was 1542 cells/mm2 (SD:601) for the ITC group and 1381 cells/mm2 (SD:618) for the standard DMEK group (P=0.25). ETDRS visual acuity at three months was 0.77 and 0.78 for the for the ITC and standard DMEK group respectively. No serious adverse event was reported in the postoperative period.

Conclusions:

The use of ITC can be a safe and feasible way to tackle early perioperative inflammation in DMEK. The reduction of early perioperative inflammation may have an influence in early graft function and postoperative endothelial density.

Financial Disclosure:

None