Clinical Comparison of Two Methods of Graft Preparation in Descemet Membrane Endothelial Keratoplasty

Rickmann, Annekatrin; Opitz, Natalia; Szurman, Peter; Boden, Karl; Jung, Sascha; Wahl, Silke; Haus, Arno; Damm, Lara-Jil; Januschowski, Kai

doi:10.1080/02713683.2017.1368086

Cited by 13 publications

(9 citation statements)

References 21 publications

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“…In this case, endothelial cell density decreased by 46$ after 6 months of DMEK. Due to manipulation and possible direct contact, this endothelial cell loss is higher than in other research groups, reporting an average endothelial cell loss of 30$ within the first 6 months [12, 13, 14]. This increased cell loss could lead to a graft failure as a result.…”

Section: Discussionmentioning

confidence: 88%

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

Helaiwa

Januschowski

Boden

et al. 2018

Case Rep Ophthalmol

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Purpose: The aim of this article is to report an unusual case of postoperative graft loss into the vitreous cavity after Descemet membrane endothelial keratoplasty (DMEK) in a patient with an unstable iris-lens diaphragm (scleral-fixated intraocular lens [sf-IOL]) and its successful retrieval with a favourable outcome. Methods: This is a retrospective case report. Results: DMEK procedure was performed in a vitrectomized eye of an 80-year-old woman with pre-existing sf-IOL due to pseudophakic bullous keratopathy. In the setting of an inadvertently created oversized Ando iridectomy and unstable iris-lens diaphragm due to sf-IOL, repeated loss of an anterior chamber gas tamponade occurred. At the 3rd postoperative day, the patient noticed a change in visual perception, and we could detect a loss of the graft into the vitreous via B-scan ultrasound. A 23-G vitrectomy was performed promptly to recover the graft using a bimanual hand-over-hand technique. Six months after DMEK, the patient had a clear cornea without dehiscences with a central corneal thickness of 533 µm and endothelial cell count of 1,219 cells/mm². Conclusions: This case demonstrates the possibility of graft recovery from the vitreous after DMEK and subsequent corneal clearing despite unstable iris-lens diaphragm and vitrectomized eye.

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Section: Discussionmentioning

confidence: 88%

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

Helaiwa

Januschowski

Boden

et al. 2018

Case Rep Ophthalmol

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“…Moreover, the endothelial cells were preserved better after the liquid bubble technique. However, other studies reported the contrary result that manual stripping technique was similar or better than liquid bubble technique . Nevertheless, the success rates were similar between the 2 techniques, so it is hard to judge which technique is more reliable and suitable for porcine corneas.…”

Section: Discussionmentioning

confidence: 93%

“…However, other studies reported the contrary result that manual stripping technique was similar or better than liquid bubble technique. 32,33 Nevertheless, the success rates were similar between the 2 techniques, so it is hard to judge which technique is more reliable and suitable for porcine 35 Considering that, we investigated the correlation in the porcine DM, and the result also indicated the same tendency. However, the porcine DMEK rolls came from WZS-pigs with different ages were all triangle-shaped, and the tightness of the rolls did not vary with their thickness.…”

Section: Wzs-24# 21 18mentioning

confidence: 97%

The feasibility and efficacy of preparing porcine Descemet’s membrane endothelial keratoplasty (DMEK) grafts by two techniques: An ex‐vivo investigation for future xeno‐DMEK

Liu

Zhang

et al. 2018

Xenotransplantation

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“…; Rickmann et al. ). Therefore, many efforts have been undertaken to reduce surgical stress factors (Bachmann et al.…”

Section: Discussionmentioning

confidence: 97%

Significant differences between specular microscopy and corneal bank endothelial cell counts – a pilot study

Rickmann

Boden

Wahl

et al. 2019

Acta Ophthalmologica

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Background: It was shown recently that endothelial cell count performed by cornea banks overestimates the real number of endothelial cells. The aim of this study was to investigate the internal quality of preclinical ECD in human donor corneas using two widely used methods for endothelial cell counting, transmitted light microscopy used in organ culture tissue bank and clinically used specular microscopy. Methods: Twenty human donor corneas that could not be transplanted were included in this analysis. Differences in evaluating endothelial cell density (ECD) and hexagonal endothelial cell ratio (HEX) between clinical specular microscopy (CSM) and corneal bank transmitted light microscope (CBLM) were evaluated as well as differences between automated and manual cell counts. Results: Automated CBLM showed a higher ECD of 31.85% compared to automated CSM, while manual CBLM counting is 10.51% higher compared to manual CSM (p < 0.01). Further, higher average ECD values result in a higher difference between CSM and CBLM measurements. The manual CBLM ECDs were significantly higher compared to automated derived ECD from CSM (p < 0.01). However, no systematic bias can be detected when comparing the differences of the measurements with the average ECD measurements of both methods.Conclusion: This preclinical pilot study confirmed a significant higher ECD using transmitted light microscopy in organ culture compared to clinical specular microscopy. This indicates that the early rapid decrease of EC universally observed after surgery might be partly artefactual.

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Clinical Comparison of Two Methods of Graft Preparation in Descemet Membrane Endothelial Keratoplasty

Abstract: Regarding the clinical outcome, we did not find a statistical significant difference between manual dissection and liquid bubble graft preparation. Both preparation techniques lead to an equivalent clinical outcome after DMEK surgery.

Cited by 13 publications

References 21 publications

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

The feasibility and efficacy of preparing porcine Descemet’s membrane endothelial keratoplasty (DMEK) grafts by two techniques: An ex‐vivo investigation for future xeno‐DMEK

Significant differences between specular microscopy and corneal bank endothelial cell counts – a pilot study

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