Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy
<b>Background:</b> Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebub...
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/6/1593 |
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| author | Nicola Cardascia Flavio Cassano Valentina Pastore Maria Gabriella La Tegola Alessandra Sborgia Francesco Boscia Giovanni Alessio |
| author_facet | Nicola Cardascia Flavio Cassano Valentina Pastore Maria Gabriella La Tegola Alessandra Sborgia Francesco Boscia Giovanni Alessio |
| author_sort | Nicola Cardascia |
| collection | DOAJ |
| description | <b>Background:</b> Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebubbling (ARB). <b>Methods:</b> Retrospectively, we investigated predictive factors related to GD between January 2016 and March 2020, a pre-COVID era, in 72 patients, 72 eyes, and their donors’ lamellar characteristics, focusing on donor’s cause of death. The patients were divided according to the posterior lamellar keratoplasty technique adopted. <b>Results:</b> GD and consequent ARB were most common but not significantly prevalent in DMEK (<i>p</i> = 0.11). It was more common in FED for both surgical approaches. Only in BK treated with DSAEK were host steeper mean astigmatism (<i>p</i> = 0.03) and donors with smaller graft pre-cut diameters (<i>p</i> = 0.02) less likely to be related to GD. Regarding donor’s cause of death, only cardiovascular accident could be related to GD in BK treated with DMEK (<i>p</i> = 0.04). <b>Conclusions:</b> Our study shows that the conventional match between pathology and corneal lenticule is not sufficient to prevent ARB. Donor’s cause of death can impair graft and host attachment. In particular, cardiovascular death may impair the efficiency of donors’ endothelial cells, inducing GD after DMEK in BK. |
| first_indexed | 2024-04-24T18:09:22Z |
| format | Article |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T18:09:22Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-93bea754be6c4ace9d3c54ac959cd8c72024-03-27T13:47:47ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01136159310.3390/jcm13061593Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous KeratopathyNicola Cardascia0Flavio Cassano1Valentina Pastore2Maria Gabriella La Tegola3Alessandra Sborgia4Francesco Boscia5Giovanni Alessio6UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, ItalyUOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Università degli Studi di Bari “Aldo Moro”, 70121 Bari, Italy<b>Background:</b> Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebubbling (ARB). <b>Methods:</b> Retrospectively, we investigated predictive factors related to GD between January 2016 and March 2020, a pre-COVID era, in 72 patients, 72 eyes, and their donors’ lamellar characteristics, focusing on donor’s cause of death. The patients were divided according to the posterior lamellar keratoplasty technique adopted. <b>Results:</b> GD and consequent ARB were most common but not significantly prevalent in DMEK (<i>p</i> = 0.11). It was more common in FED for both surgical approaches. Only in BK treated with DSAEK were host steeper mean astigmatism (<i>p</i> = 0.03) and donors with smaller graft pre-cut diameters (<i>p</i> = 0.02) less likely to be related to GD. Regarding donor’s cause of death, only cardiovascular accident could be related to GD in BK treated with DMEK (<i>p</i> = 0.04). <b>Conclusions:</b> Our study shows that the conventional match between pathology and corneal lenticule is not sufficient to prevent ARB. Donor’s cause of death can impair graft and host attachment. In particular, cardiovascular death may impair the efficiency of donors’ endothelial cells, inducing GD after DMEK in BK.https://www.mdpi.com/2077-0383/13/6/1593corneal dystrophiescorneal transplantationdiseases of the ocular surfacephacoemulsificationpost-operative anterior segment problemscomplications of refractive surgery |
| spellingShingle | Nicola Cardascia Flavio Cassano Valentina Pastore Maria Gabriella La Tegola Alessandra Sborgia Francesco Boscia Giovanni Alessio Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy Journal of Clinical Medicine corneal dystrophies corneal transplantation diseases of the ocular surface phacoemulsification post-operative anterior segment problems complications of refractive surgery |
| title | Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy |
| title_full | Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy |
| title_fullStr | Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy |
| title_full_unstemmed | Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy |
| title_short | Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy |
| title_sort | donor characteristics in graft detachment after posterior lamellar keratoplasty for fuchs endothelial dystrophy and bullous keratopathy |
| topic | corneal dystrophies corneal transplantation diseases of the ocular surface phacoemulsification post-operative anterior segment problems complications of refractive surgery |
| url | https://www.mdpi.com/2077-0383/13/6/1593 |
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