Factors Affecting the Success Rate of Preloaded Descemet Membrane Endothelial Keratoplasty With Endothelium-Inward Technique: A Multicenter Clinical Study.

Cell Count Corneal Endothelial Cell Loss / diagnosis Descemet Membrane / surgery Descemet Stripping Endothelial Keratoplasty / methods Endothelium, Corneal / transplantation Fuchs' Endothelial Dystrophy / surgery Humans Retrospective Studies

Journal

American journal of ophthalmology
ISSN: 1879-1891
Titre abrégé: Am J Ophthalmol
Pays: United States
ID NLM: 0370500

Informations de publication

Date de publication:
09 2022
Historique:
received: 26 08 2021
revised: 01 03 2022
accepted: 03 03 2022
pubmed: 16 3 2022
medline: 9 9 2022
entrez: 15 3 2022
Statut: ppublish

Résumé

To evaluate factors affecting the outcomes of preloaded Descemet membrane endothelial keratoplasty (pl-DMEK) with endothelium-inward. Retrospective clinical case series and a comparative tissue preparation study. Participants: Fifty-five donor tissues for ex vivo study and 147 eyes of 147 patients indicated with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy with or without cataract. Standardized DMEK peeling was performed with 9.5-mm-diameter trephination followed by second trephination for loading the graft (8.0-9.5 mm diameter). The tissues were manually preloaded with endothelium-inward and preserved for 4 days or shipped for transplantation. Live and dead assay and immunostaining was performed on ex vivo tissues. For the clinical study, the tissues were delivered using bimanual pull-through technique followed by air tamponade at all the centers. Tissue characteristics, donor and recipient factors, rebubbling rate, endothelial cell loss (ECL), and corrected distance visual acuity (CDVA) at 3, 6, and 12 months. At day 4, significant cell loss (P = .04) was observed in pl-DMEK with loss of biomarker expression seen in prestripped and pl-DMEK tissues. Rebubbling was observed in 40.24% cases. Average ECL at 3, 6, and 12 months was 45.87%, 40.98%, and 47.54%, respectively. CDVA improved significantly at 3 months postoperation (0.23 ± 0.37 logMAR) (P < .01) compared to the baseline (0.79 ± 0.61 logMAR). A significant association (P < .05) between graft diameter, preservation time, recipient gender, gender mismatch, and recipient age to rebubbling rate was observed. Graft loading to delivery time of pl-DMEK tissues in endothelium-inward fashion must be limited to 4 days after processing. Rebubbling rate and overall surgical outcomes following preloaded DMEK can be multifactorial and center-specific.

Identifiants

DOI: 10.1016/j.ajo.2022.03.009 PMID: 35288072
pubmed: 35288072
pii: S0002-9394(22)00102-7
doi: 10.1016/j.ajo.2022.03.009
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

272-281

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Mohit Parekh (M)

From the Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School (M.P.), Boston, Massachusetts, USA.

Emilio Pedrotti (E)

Department of Ophthalmology, University of Verona (E.P., E.B.), Verona, Italy.

Pietro Viola (P)

Department of Ophthalmology, San Bartolo Hospital (P.V., E.N.), Vicenza, Italy.

Pia Leon (P)

Department of Ophthalmology, SS Giovanni e Paolo Hospital (P.L.), Venice, Italy; International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus (P.L., L.B., A.R., D.P., S.F.), Venice, Italy.

Enrico Neri (E)

Department of Ophthalmology, San Bartolo Hospital (P.V., E.N.), Vicenza, Italy.

Lorenzo Bosio (L)

International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus (P.L., L.B., A.R., D.P., S.F.), Venice, Italy.

Erika Bonacci (E)

Department of Ophthalmology, University of Verona (E.P., E.B.), Verona, Italy.

Alessandro Ruzza (A)

International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus (P.L., L.B., A.R., D.P., S.F.), Venice, Italy.

Stephen B Kaye (SB)

St. Paul's Eye Unit, Royal Liverpool University Hospital (S.B.K., V.R.), Liverpool, UK; Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool (S.B.K., V.R.), Liverpool, UK.

Diego Ponzin (D)

International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus (P.L., L.B., A.R., D.P., S.F.), Venice, Italy.

Stefano Ferrari (S)

International Center for Ocular Physiopathology, Fondazione Banca degli Occhi del Veneto Onlus (P.L., L.B., A.R., D.P., S.F.), Venice, Italy.

Vito Romano (V)

St. Paul's Eye Unit, Royal Liverpool University Hospital (S.B.K., V.R.), Liverpool, UK; Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool (S.B.K., V.R.), Liverpool, UK; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia (V.R.), Brescia, Italy; Instituto Universitario Fernandez-Vega, Universidad de Oviedo, and Fundacion de Investigacion on Oftalmologica (V.R.), Oviedo, Asturias, Spain. Electronic address: vito.romano@gmail.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Phénomènes physiologiques cellulaires › Numération cellulaire › Factors Affecting the Success Rate of...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations oculaires › Perte de cellules endothéliales cornéennes › Factors Affecting the Success Rate of...
questionsmedicales.fr › Tissus › Membranes › Membrane basale › Lame limitante postérieure › Factors Affecting the Success Rate of...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation de tissu › Kératoplastie endothéliale automatisée par le stripping de Descemet › Factors Affecting the Success Rate of...
questionsmedicales.fr › Tissus › Épithélium › Endothélium › Endothélium de la cornée › Factors Affecting the Success Rate of...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Maladies génétiques congénitales › Maladies héréditaires de l'oeil › Dystrophies héréditaires de la cornée › Dystrophie endothéliale de Fuchs › Factors Affecting the Success Rate of...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Factors Affecting the Success Rate of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Factors Affecting the Success Rate of...