Effect of the position of the corneal lamella on the frequency of its detachment
AIM: To determine the influence of gaps [places where neither the donor's nor the recipient's Descemet's membrane (DM) is present] and overlaps (places where the recipient's DM is covered by the donor's DM) on the frequency of postoperative detachment of DM endothelial kerat...
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| Format: | Article |
| Language: | English |
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Press of International Journal of Ophthalmology (IJO PRESS)
2022-12-01
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| Series: | International Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://ies.ijo.cn/en_publish/2022/12/20221207.pdf |
| _version_ | 1811316756677918720 |
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| author | Pavel Studeny Magdalena Netukova Martina Nemcokova Yun-Min Klimesova Deli Krizova |
| author_facet | Pavel Studeny Magdalena Netukova Martina Nemcokova Yun-Min Klimesova Deli Krizova |
| author_sort | Pavel Studeny |
| collection | DOAJ |
| description | AIM: To determine the influence of gaps [places where neither the donor's nor the recipient's Descemet's membrane (DM) is present] and overlaps (places where the recipient's DM is covered by the donor's DM) on the frequency of postoperative detachment of DM endothelial keratoplasty (DMEK) lamellae. METHODS: Totally 64 eyes of 64 patients with Fuchs' endothelial dystrophy or bullous keratopathy indicated for DMEK were randomly divided in two groups. The diameter of the implanted DMEK lamella was the same in both groups (8 mm), but we changed the diameter of the removed recipient DM. In the first group (32 eyes), the circular area was approximately 8.5 mm (gaps); in the second group (32 eyes), the diameter was 7.5 mm (overlaps). Postoperatively we noted all cases of detachment visible on the slit lamp and these cases we indicated for rebubbling. We also measured the uncorrected distance visual acuity (UDVA) as well as corrected distance visual acuity (CDVA) in decimal and postoperative endothelial cell density (ECD). The minimum follow-up time was 6mo. RESULTS: The number of rebubbling procedures in the entire group of patients was 13, i.e., 20.3%, with 6 eyes (18.7%) in the gap group, and 7 eyes (21.9%) in the overlap group. Lamella replacement (re-DMEK) was required in 3 (gap group) and 2 patients (overlap group), respectively. The difference between the groups was statistically insignificant. The UDVA was 0.54±0.21 in the gap group and 0.58±0.24 in the overlap group. The CDVA was 0.74±0.22 and 0.80±0.16, respectively. ECD was 1920±491 and 2149±570 cells/mm2. The small differences between both groups were not statistically significant. CONCLUSION: We do not notice any difference in the group of patients with overlaps or gaps of DM. The presence of small areas of gaps or overlaps does not affect the frequency of detachment of the DMEK lamellae. |
| first_indexed | 2024-04-13T11:55:06Z |
| format | Article |
| id | doaj.art-628f3027a9904c4f91ae889e20bdb672 |
| institution | Directory Open Access Journal |
| issn | 2222-3959 2227-4898 |
| language | English |
| last_indexed | 2024-04-13T11:55:06Z |
| publishDate | 2022-12-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj.art-628f3027a9904c4f91ae889e20bdb6722022-12-22T02:47:56ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982022-12-0115121940194310.18240/ijo.2022.12.0720221207Effect of the position of the corneal lamella on the frequency of its detachmentPavel Studeny0Magdalena Netukova1Martina Nemcokova2Yun-Min Klimesova3Deli Krizova4Pavel Studeny. FNKV, Srobarova 50, Prague 10034, Czech Republic. studenypavel@seznam.czDepartment of Ophthalmology, University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague 10034, Czech RepublicDepartment of Ophthalmology, University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague 10034, Czech RepublicDepartment of Ophthalmology, University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague 10034, Czech RepublicDepartment of Ophthalmology, University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague 10034, Czech RepublicAIM: To determine the influence of gaps [places where neither the donor's nor the recipient's Descemet's membrane (DM) is present] and overlaps (places where the recipient's DM is covered by the donor's DM) on the frequency of postoperative detachment of DM endothelial keratoplasty (DMEK) lamellae. METHODS: Totally 64 eyes of 64 patients with Fuchs' endothelial dystrophy or bullous keratopathy indicated for DMEK were randomly divided in two groups. The diameter of the implanted DMEK lamella was the same in both groups (8 mm), but we changed the diameter of the removed recipient DM. In the first group (32 eyes), the circular area was approximately 8.5 mm (gaps); in the second group (32 eyes), the diameter was 7.5 mm (overlaps). Postoperatively we noted all cases of detachment visible on the slit lamp and these cases we indicated for rebubbling. We also measured the uncorrected distance visual acuity (UDVA) as well as corrected distance visual acuity (CDVA) in decimal and postoperative endothelial cell density (ECD). The minimum follow-up time was 6mo. RESULTS: The number of rebubbling procedures in the entire group of patients was 13, i.e., 20.3%, with 6 eyes (18.7%) in the gap group, and 7 eyes (21.9%) in the overlap group. Lamella replacement (re-DMEK) was required in 3 (gap group) and 2 patients (overlap group), respectively. The difference between the groups was statistically insignificant. The UDVA was 0.54±0.21 in the gap group and 0.58±0.24 in the overlap group. The CDVA was 0.74±0.22 and 0.80±0.16, respectively. ECD was 1920±491 and 2149±570 cells/mm2. The small differences between both groups were not statistically significant. CONCLUSION: We do not notice any difference in the group of patients with overlaps or gaps of DM. The presence of small areas of gaps or overlaps does not affect the frequency of detachment of the DMEK lamellae.http://ies.ijo.cn/en_publish/2022/12/20221207.pdfcentrally positioned descemet graftdescemet graft detachmentdescemet membrane endothelial keratoplastyposterior lamellar keratoplastyrecovery of corneal transparency |
| spellingShingle | Pavel Studeny Magdalena Netukova Martina Nemcokova Yun-Min Klimesova Deli Krizova Effect of the position of the corneal lamella on the frequency of its detachment International Journal of Ophthalmology centrally positioned descemet graft descemet graft detachment descemet membrane endothelial keratoplasty posterior lamellar keratoplasty recovery of corneal transparency |
| title | Effect of the position of the corneal lamella on the frequency of its detachment |
| title_full | Effect of the position of the corneal lamella on the frequency of its detachment |
| title_fullStr | Effect of the position of the corneal lamella on the frequency of its detachment |
| title_full_unstemmed | Effect of the position of the corneal lamella on the frequency of its detachment |
| title_short | Effect of the position of the corneal lamella on the frequency of its detachment |
| title_sort | effect of the position of the corneal lamella on the frequency of its detachment |
| topic | centrally positioned descemet graft descemet graft detachment descemet membrane endothelial keratoplasty posterior lamellar keratoplasty recovery of corneal transparency |
| url | http://ies.ijo.cn/en_publish/2022/12/20221207.pdf |
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