Skip to main content

Advertisement

SpringerLink
Log in

Outcomes of Descemet’s membrane keratoplasty in graft failure after penetrating keratoplasty

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the outcomes and identify the risk factors of failure in Descemet’s membrane endothelial keratoplasty (DMEK) for graft failure after penetrating keratoplasty (PKP).

Methods

Medical records and surgical videos of patients who underwent DMEK for graft failure after PKP were reviewed in this retrospective study. Demographic data, the indication for PKP, number of previous PKPs, duration between the last PKP and graft failure, graft diameter at the last PKP, best-corrected visual acuity (logMAR) before and after DMEK, preoperative additional ocular diseases, and intraoperative and postoperative complications were recorded. Descemet's membrane (DM) attachment was examined on the first day and the first month, postoperatively, and at the last follow-up visit. The patients were divided into two groups according to DM attachment at the last visit (group 1, patients with attached DM; group 2, patients with DM detachment).

Results

Twenty eyes of 20 patients were included in this study. At the last follow-up visit, DM was attached in 13 (65%) patients (Group 1) and detached in 7 (35%) cases (Group 2). The BCVA was improved significantly after DMEK in all patients (2.10 ± 0.4, preoperatively; 1.09 ± 0.8, postoperatively; p = 0.005). There were no significant differences between groups, in terms of age, the number and indication for PKP, the time between the last PKP and DMEK, or history of glaucoma. PKP was performed in all patients in group 2.

Conclusion

DMEK is a feasible option with fast visual recovery and a low risk of complications in patients with graft failure after PKP. We found no risk factors for the DM graft detachment, so larger studies are needed to analyze intraoperative or donor-related factors as well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Dunn SP, Gal RL, Kollman C et al (2014) Writing Committee for the Cornea Donor Study Research Group. Corneal graft rejection 10 years after penetrating keratoplasty in the cornea donor study. Cornea 33:1003–1009

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ang M, Ho H, Wong C, Htoon HM, Mehta JS, Tan D (2014) Endothelial keratoplasty after failed penetrating keratoplasty: an alternative to repeat penetrating keratoplasty. Am J Ophthalmol 158:1221-1227.e1

    Article  PubMed  Google Scholar 

  3. Einan Lifshitz A, Belkin A, Sorkin N, Mednick Z, Boutin T, Gill I, Karimi M, Chan CC, Rootman DS (2018) Descemet membrane endothelial keratoplasty after penetrating keratoplasty: features for success. Cornea 37:1093–1097

    Article  PubMed  Google Scholar 

  4. Lavy I, Liarakos VS, Verdijk RM, Parker J, Müller TM, Bruinsma M, Binder PS, Melles GRJ (2017) Outcome and histopathology of secondary penetrating keratoplasty graft failure managed by descemet membrane endothelial keratoplasty. Cornea 36:777–784

    Article  PubMed  Google Scholar 

  5. Heinzelmann S, Böhringer D, Eberwein P, Schrader S, Geerling G (2017) Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty. Graefe’s Arch Clin Exp Ophthalmol 255:979–985

    Article  Google Scholar 

  6. Groeneveld-van Beek EA, Lie JT, van der Wees J, Bruinsma M, Melles GRJ (2013) Standardized “no-touch” donor tissue preparation for DALK and DMEK: harvesting undamaged anterior and posterior transplants from the same donor cornea. Acta Ophthalmol 91:145–150

    Article  CAS  PubMed  Google Scholar 

  7. Dapena I, Moutsouris K, Droutsas K, Ham L, van Dijk K, Melles GRJ (2011) Standardized “no-touch” technique for Descemet membrane endothelial keratoplasty. Arch Ophthalmol 129:88–94

    Article  PubMed  Google Scholar 

  8. Koçluk Y, Kasım B, Sukgen EA, Burcu A (2018) Descemet membrane endothelial keratoplasty (DMEK): intraoperative and postoperative complications and clinical results. Arq Bras Oftalmol 81:212–218

    Article  PubMed  Google Scholar 

  9. Woo JH, Ang M, Htoon HM, Tan D (2019) Descemet membrane endothelial keratoplasty versus descemet stripping automated endothelial keratoplasty and penetrating keratoplasty. Am J Ophthalmol 207:288–303

    Article  PubMed  Google Scholar 

  10. Pavlovic I, Shajari M, Herrmann E, Schmack I, Lencova A, Kohnen T (2017) Meta-analysis of postoperative outcome parameters comparing descemet membrane endothelial keratoplasty versus descemet stripping automated endothelial keratoplasty. Cornea 36:1445–1451

    Article  PubMed  Google Scholar 

  11. Alió Del Barrio JL, Bhogal M, Ang M, Ziaei M, Robbie S, Montesel A, Gore DM, Mehta JS, Alió JL (2021) Corneal transplantation after failed grafts: options and outcomes. Surv Ophthalmol 66:20–40

    Article  PubMed  Google Scholar 

  12. Anshu A, Li L, Htoon HM, de Benito-Llopis L, Shuang LS, Singh MJ, Hwee TDT (2021) Long-term review of penetrating keratoplasty: a 20-year review in asian eyes. Am J Ophthalmol 224:254–266

    Article  PubMed  Google Scholar 

  13. Sorkin N, Trinh T, Einan-Lifshitz A, Mednick Z, Santaella G, Telli A, Belkin A, Chan CC, Rootman DS (2019) Outcomes of femtosecond laser-assisted Descemet membrane endothelial keratoplasty for failed penetrating keratoplasty. Can J Ophthalmol 54:741–745

    Article  PubMed  Google Scholar 

  14. Pasari A, Price MO, Feng MT, Price FW (2019) Descemet membrane endothelial keratoplasty for failed penetrating keratoplasty: visual outcomes and graft failure. Cornea 38:151–156

    Article  PubMed  Google Scholar 

  15. Ang M, Sng CCA (2018) Descemet membrane endothelial keratoplasty and glaucoma. Curr Opin Ophthalmol 29:178–184

    Article  PubMed  Google Scholar 

  16. Treder M, Alnawaiseh M, Eter N (2017) Descemet membrane endothelial keratoplasty (DMEK) early stage graft failure in eyes with preexisting glaucoma. Graefes Arch Clin Exp Ophthalmol 255:1417–1421

    Article  CAS  PubMed  Google Scholar 

  17. Nottage J, Nirankari VS (2012) Endothelial keratoplasty without Descemet’s stripping in eyes with previous penetrating corneal transplants. Br J Ophthalmol 96:24–27

    Article  PubMed  Google Scholar 

  18. Heitor de Paula F, Kamyar R, Shtein RM, Sugar A, Mian SI (2012) Endothelial keratoplasty without Descemet stripping after failed penetrating keratoplasty. Cornea 31:645–648

    Article  PubMed  Google Scholar 

  19. Alió Del Barrio JL, Montesel A, Ho V, Bhogal M (2020) Descemet membrane endothelial keratoplasty under failed penetrating keratoplasty without host descemetorhexis for the management of secondary graft failure. Cornea 39:13–17

    Article  PubMed  Google Scholar 

Download references

Funding

The authors declare no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Adana City Training and Research Hospital, Yüreğir, 01220, Adana, Turkey

    Burcu Kasım & Yusuf Koçluk

Authors
  1. Burcu Kasım
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yusuf Koçluk
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study and design. Material preparation, data collection and analysis were performed by BK and YK. The first draft of the manuscript was written by BK and YK commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Burcu Kasım.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

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

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kasım, B., Koçluk, Y. Outcomes of Descemet’s membrane keratoplasty in graft failure after penetrating keratoplasty. Int Ophthalmol 43, 3185–3191 (2023). https://doi.org/10.1007/s10792-023-02718-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-023-02718-x

Keywords

Search

Navigation