Descemet Membrane Endothelial Keratoplasty for Failed Deep Anterior Lamellar Keratoplasty: A Case Series

Cornea
Adi Einan-LifshitzDavid S Rootman

Abstract

To suggest a new surgical approach for posterior opacities or persistent Descemet membrane (DM) detachment in failed deep anterior lamellar keratoplasty (DALK) and to report the outcome of Descemet membrane endothelial keratoplasty (DMEK) in a series of patients with DALK failure. In this retrospective case series of patients who underwent DMEK for failed DALK at Toronto Western Hospital, 4 patients with failed DALK who underwent DMEK surgery were included. In all 4 cases, big bubble formation during initial DALK surgery had failed and the surgical technique was converted to manual dissection using the Melles technique. In 2 cases, the descemetorhexis in DMEK surgery was performed manually, and in 2 cases, the descemetorhexis was performed with the assistance of the femtosecond laser. Four eyes of 4 patients aged 70 ± 4 years were included. Average follow-up time was 9 ± 5 months. Indications for DALK surgery were corneal dystrophy in 2 patients and corneal scars in the other 2. DALK failure was due to persistent DM detachment that created a double chamber in 2 patients and due to posterior lamellar haze in the other 2. After DMEK surgery, 2 patients had graft detachment and required rebubbling. In 1 patient, the DMEK scroll wa...Continue Reading

References

Jun 12, 1999·The British Journal of Ophthalmology·G R MellesP S Binder
Jul 26, 2002·American Journal of Ophthalmology·Jun ShimazakiKazuo Tsubota
Mar 12, 2004·American Journal of Ophthalmology·Bart T H van DoorenGerrit R J Melles
Feb 7, 2006·American Journal of Ophthalmology·Rajesh Fogla, Prema Padmanabhan
Nov 15, 2006·Cornea·Gerrit R J MellesJacqueline van der Wees
Feb 22, 2011·American Journal of Ophthalmology·Anil KubalogluYusuf Ozertürk
Mar 13, 2012·Cornea·Vincenzo SarnicolaAndrew Ruggiero
Jul 24, 2012·Cornea·Efdal YoeruekKarl-Ulrich Bartz-Schmidt
Feb 5, 2014·Ophthalmology·Douglas J CosterUNKNOWN Australian Corneal Graft Registry Contributors
Dec 25, 2015·The British Journal of Ophthalmology·Akiko OgawaJun Shimazaki
Feb 27, 2017·Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie·Ryan LeNeeru Gupta
Mar 4, 2020·Journal of Cataract and Refractive Surgery·Michael W BelinRenato Ambrosio

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Citations

May 2, 2021·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·Felix HagenauNikolaus Luft

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