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Descemet membrane endothelial keratoplasty in eyes with glaucoma implants
- Source :
- Optometry and vision science : official publication of the American Academy of Optometry. 90(9)
- Publication Year :
- 2013
-
Abstract
- Purpose This study aims to analyze the feasibility of Descemet membrane endothelial keratoplasty (DMEK) in the management of corneal endothelial decompensation in eyes with glaucoma implants. Case report A 62-year-old male with bullous keratopathy after trabeculectomy and Baerveldt shunt implantation for contusion glaucoma of the right eye (case 1) underwent surgical tube trimming with a DMEK procedure. A 54-year-old male with Descemet stripping automated endothelial keratoplasty (DSAEK) failure and dislocation in the presence of an Ahmed glaucoma valve and an artificial iris in the right eye (case 2) was treated by removal of the DSAEK graft and subsequent DMEK procedure. In both eyes, the DMEK graft could be successfully inserted, unfolded, positioned in front of the glaucoma tube, and attached to the host stroma by air injection into the anterior chamber. Postoperatively, both corneas cleared with complete graft attachment and stable glaucoma tube position. After 3 days, peripheral graft detachment occurred in case 1 and was managed successfully with one intracameral air reinjection. Case 2 revealed intraocular pressure (IOP) elevation up to 30 mm Hg in the immediate postoperative period, treated successfully by antiglaucoma medications. Within 1-year follow-up, visual acuity improved from hand movements to 20/63 and 20/32, respectively; endothelial cell density decreased by 36% and 42%, respectively; and the IOP ranged between 7 and 14 mm Hg in both cases without treatment. Conclusions Descemet membrane endothelial keratoplasty seems to be feasible in the management of corneal endothelial decompensation in eyes with glaucoma implants. Graft attachment, IOP, and endothelial cell density should be followed up closely.
- Subjects :
- Male
medicine.medical_specialty
Intraocular pressure
Visual acuity
genetic structures
medicine.medical_treatment
Visual Acuity
Glaucoma
Trabeculectomy
Glaucoma valve
Tonometry, Ocular
Postoperative Complications
Ophthalmology
medicine
Glaucoma surgery
Humans
Glaucoma Drainage Implants
Intraocular Pressure
business.industry
Corneal Edema
Endothelium, Corneal
Middle Aged
medicine.disease
eye diseases
Descemet Stripping Endothelial Keratoplasty
Bullous keratopathy
sense organs
medicine.symptom
business
Optometry
Subjects
Details
- ISSN :
- 15389235
- Volume :
- 90
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Optometry and vision science : official publication of the American Academy of Optometry
- Accession number :
- edsair.doi.dedup.....3535cac43ab2aa608394956a7bda4c2d