Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Sbarbaro, James A; Eagle, Ralph C.; Thumma, Prathima; Raber, Irving M.

doi:10.1097/ico.0b013e318170aeb7

Cited by 13 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 Sbarbaro et al reported a faint RCFM in two of their three failed grafts and suggested RCFM as possible aetiology for EK failure. 5 In contrast, the RCFM in our case was thick and visible through the oedematous cornea.…”

Section: Discussioncontrasting

confidence: 73%

“…In summary, the relatively new complication of RCFM may develop post DSEK, and surgeons should look out for it. However, it is not known if RCFM formation is secondary to failed grafts or actually the cause 4,5 . The incidence of its development post DSEK may be different to the rates reported in conventional PK and may be different for automated DSEK.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

Young,

Tam,

Lau

et al. 2009

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 97%

Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

Young,

Tam,

Lau

et al. 2009

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

“…These include lenticule dislocation, interface fibrosis or hemorrhage, epithelial downgrowth [14-16]. …”

Section: Resultsmentioning

confidence: 99%

In vivo evaluation of DSAEK interface with scanning-laser confocal microscopy

et al. 2012

View full text Add to dashboard Cite

BackgroundDescemet Stripping Automated Endothelial Keratoplasty (DSAEK) allows selective replacement of the endothelium. Post-operative haze and particles can affect the interface quality and, ultimately, visual outcome. In this study, we evaluated DSAEK interface with in vivo laser confocal microscopy (LCM) in order to: (i) correlate interface status with best corrected visual acuity, and (ii) with time from surgery; (iii) correlate interface particle number with best corrected visual acuity. Host-donor interface was imaged and graded using a published reflectivity scale. Particles at the interface were counted.Methods18 eyes of 16 patients (6 males and 10 females); mean age: 74 ± 8.3 years which underwent DSAEK were examined by means of in vivo laser confocal microscopy between 1 and 24 months after surgery. Host-donor interface was imaged and graded using a published reflectivity scale. Particles present at the interface were counted.ResultsInterface reflectivity was 2.17 ± 1.2 and significantly correlated with visual acuity (Spearman correlation coefficient −0.83; P < 0.001), and with time after surgery (Spearman correlation coefficient −0.87; P < 0.001). Visual acuity was 0.67 ± 0.27. The number of particles was 205 ± 117.8; no correlation was found between this number and visual acuity (Spearman correlation coefficient −0.41; P = 0.15).ConclusionDSAEK interface imaged with LCM is helpful in diagnosing poor host-donor interface quality in DSAEK surgery. A good quality interface is related to a better visual acuity. Moreover, the quality of the interface appears to improve as time passes from the surgery. Interface quality is related with visual acuity and improves with time from surgery. LCM should be considered as an added tool in post-DSAEK follow-up of patients. Finally, our study shows that the presence of particles does not influence visual outcome.

show abstract

“…However, the adherence of endothelial grafts to residual Descemet's membrane after incomplete scraping suggests that it may not be necessary to remove the optically clear Descemet's membrane in order to achieve a good graft attachment [13] . Our case also showed good graft adherence to Descemet's membrane of the failed penetrating graft without any clinical sign of the weakness of the interface wound; yet, this weakness may be expected to cause graft dislocation in a blunt ocular trauma.…”

Section: Discussionmentioning

confidence: 99%

Endothelial Keratoplasty without Descemet’s Membrane Stripping: Histologic and Ultrastructural Findings

et al. 2009

View full text Add to dashboard Cite

Aim: To report histologic and ultrastructural findings of endothelial keratoplasty (EK) performed without Descemet’s membrane stripping. Methods: Clinical techniques, histology, and transmission electron microscopy. Results: A 55-year-old woman was referred to us, after 2 unsuccessful penetrating keratoplasties (PKs), for pseudophakic bullous keratopathy. An 8.0-mm EK without Descemet’s membrane stripping was performed, and clarity was restored to the failed penetrating regraft. A year later, the lamellar graft failed, and a third PK was performed for intractable corneal edema. Light microscopy of a semi-thin section of the trephined corneal button showed both the recipient’s and the donor’s Descemet’s membrane, the well-preserved structure of the full-thickness graft, and marked edema of the adherent stromal carrier of the endothelial transplant. The host endothelium was absent at the interface, and the donor endothelium was atrophic. Electron microscopy revealed regularity and even spacing of collagen fibrils as well as quiet keratocytes on both sides of Descemet’s membrane at PK-EK interface. Conclusion: These findings suggest a lack of proliferation and hypercellular scarring, and offer further support to the already proven merits of EK.

show abstract

Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Cited by 13 publications

References 16 publications

Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

In vivo evaluation of DSAEK interface with scanning-laser confocal microscopy

Endothelial Keratoplasty without Descemet’s Membrane Stripping: Histologic and Ultrastructural Findings

Contact Info

Product

Resources

About