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DOI: 10.1055/a-1533-2149
Outcomes of Repair of Total Graft Detachment following Descemetʼs Membrane Endothelial Keratoplasty
Article in several languages: English | deutsch
Abstract
Objective To present the outcomes of attempts to salvage total graft detachment following Descemetʼs membrane endothelial keratoplasty (DMEK).
Methods A search of the electronic medical records of two tertiary medical centers for all patients who underwent DMEK yielded six cases of postoperative total graft detachment (2.54%). Graft salvage was attempted in all cases using repeated intracameral graft staining, unfolding, and reattachment to the stroma under 20% hexafluoride gas.
Results In all cases, a free-floating totally detached graft was identified in the anterior chamber shortly after surgery. Salvage surgery resulted in a central, well-oriented, and fully attached graft. In three cases, the primary graft failed, and in two, the corneas cleared at first but failed after 2 months and 1 year respectively. In one case, the cornea remained clear during 1 year of follow-up but had a very low endothelial cell density.
Conclusion Reattachment of fully detached DMEK graft is technically possible, but graft manipulation during the primary and secondary operations is likely to damage the endothelial cells, resulting in primary or early graft failure. If graft salvage is attempted, the probability of primary or early graft failure should be discussed with the patient, and expectations should be tempered accordingly.
Publication History
Received: 26 January 2021
Accepted: 16 June 2021
Article published online:
15 September 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
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