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Analysis of different types of anesthesia in descemet membrane endothelial keratoplasty

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Abstract

Purpose

The purpose of this study is to compare the safety and clinical results of descemet membrane endothelial keratoplasty (DMEK) in topical, peribulbar or general anesthesia.

Methods

This is a retrospective, post hoc matched study of 120 patients having received DMEK surgery with different types of anesthesia (n = 40 topical, n = 40 peribulbar, n = 40 general anesthesia). Endpoint criteria were intraoperative complications, endothelial cell count, central corneal thickness and graft rejection rate, rebubbling rate and best-corrected visual acuity after 1, 3 and 6 months.

Results

The group with topical anesthesia showed more often intraoperative difficulties such as vitreous pressure (p < 0.05), difficult graft unfolding (p = 0.14) and patient restlessness (p = 0.07). However, all three groups achieved comparable functional visual results after 6 months (p = 0.96).

Conclusion

DMEK in topical anesthesia is feasible and shows comparable final visual results but should be restricted to selected cooperative patients and performed by experienced surgeons due to possible higher intraoperative challenges.

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Acknowledgements

We thank Dr. Maria della Volpe Waizel for editing the manuscript.

Funding

No funding was received for this research.

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Authors and Affiliations

  1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach/Saar, Germany

    Annekatrin Rickmann, Christoph Andres, Karl Boden, Silke Wahl & Peter Szurman

  2. Centre for Ophthalmology, University Eye Clinic Tuebingen, Tuebingen, Germany

    Peter Szurman

Authors
  1. Annekatrin Rickmann
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  2. Christoph Andres
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  3. Karl Boden
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  4. Silke Wahl
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  5. Peter Szurman
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Corresponding author

Correspondence to Annekatrin Rickmann.

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Conflict of interest

Peter Szurman has a patent for the DMEK injector (EP2533724 B1; WO2012065602 A3).

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Sascha Jung: no affiliations, statistical analysis.

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Rickmann, A., Andres, C., Boden, K. et al. Analysis of different types of anesthesia in descemet membrane endothelial keratoplasty. Int Ophthalmol 40, 541–545 (2020). https://doi.org/10.1007/s10792-019-01210-9

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  • DOI: https://doi.org/10.1007/s10792-019-01210-9

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