Outcomes of Repair of Total Graft Detachment following Descemet?s Membrane Endothelial Keratoplasty

Translated title of the contribution: Outcomes of Repair of Total Graft Detachment following Descemet?s Membrane Endothelial Keratoplasty

Avital Adler, Eliane Rozanes, Peter Ciechanowski, Yoav Nahum, Shmuel Graffi, Uri Elbaz, Irit Bahar, Eitan Livny*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To present the outcomes of attempts to salvage total graft detachment following Descemet?s 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.

Translated title of the contributionOutcomes of Repair of Total Graft Detachment following Descemet?s Membrane Endothelial Keratoplasty
Original languageEnglish
Pages (from-to)1236-1239
Number of pages4
JournalKlinische Monatsblatter fur Augenheilkunde
Volume238
Issue number11
DOIs
StatePublished - 1 Nov 2021

Keywords

  • DMEK
  • cornea
  • graft detachment

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