在这项前瞻性队列研究中,Price (p. xxx) 等人基于糖尿病患者角膜内皮移植研究(Diabetes Endothelial Keratoplasty Study [DEKS])这一随机、双盲、多中心临床试验的预先设定的次级分析,探讨了与Descemet膜内皮角膜移植术(DMEK)术后1年成功相关的因素。研究发现,在供体、供体角膜组织、受体及手术操作等广泛变量范围内,DMEK均具有较高的成功率。1421例DMEK移植物中,有1374例(96.7%)在术后1年保持角膜透明。移植失败主要与术后早期角膜未能恢复透明有关。其中,12例(0.8%)在围手术期并发症发生后出现早期失败,32例(2.3%)发生原发性供体移植物失败。在术后8周至1年期间,仅发生3例晚期失败(0.2%)。在DEKS研究中,发生术中并发症是唯一与术后1年移植物失败具有统计学显著相关性的危险因素。供体术前角膜内皮细胞密度较高、由术者全程完成供体组织制备,以及受体无糖尿病,均与略高的移植成功率相关,但这些关联未达到统计学显著性。本研究的局限性包括:移植物失败事件数量较少,限制了评估相关因素的统计效能;未分析术后并发症或后续手术操作;研究结果可能不适用于更复杂的DMEK病例。作者总结,在广泛的临床变量范围内,DMEK术后1年的成功率均较高,而发生术中并发症的病例,其移植成功率较低。

Statin use and risk of repeat RD repair, avacincaptad pegol for GA, genetic overlaps between myopia and OAG, the most commonly prescribed post-DMEK corticosteroid, symptoms that lead to faster treatment of giant cell arteritis

YouTube video by JacquesDutroncVEVO

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The novel microbubble air injection system is a feasible modification for DMEK surgery. Ergonomic customization based on the surgeon’s hand size is critical.

Alanya’da ilk DMEK ameliyatı başarıyla gerçekleşti; 6 hasta olumlu sonuç aldı ve görme kaliteleri hızla iyileşti.

Post-keratoplasty glaucoma complicates endothelial keratoplasty, but its incidence with modern techniques remains uncertain. We conducted a systematic review estimating the pooled incidence of de novo glaucoma and ocular hypertension (OHT) in glaucoma-naïve adult eyes undergoing Descemet membrane endothelial keratoplasty (DMEK) or Descemet stripping automated endothelial keratoplasty (DSAEK).

To pool estimates of graft survival, endothelial cell loss, and complication rates following endothelial keratoplasty (EK) in eyes with prior glaucoma surgery, and to compare outcomes between Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).

Corneal transplantation is the most common allogenic transplant performed worldwide.1 Although the use of Descemet’s membrane endothelial keratoplasty (DMEK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) has increased for the treatment of corneal endothelial disorders, full-thickness replacement via penetrating keratoplasty (PK) remains a common method of transplantation for pathology involving the stroma or the entire cornea.2 Commonly reported indications for PK include keratoconus, postinfectious corneal scarring or thinning, and pseudophakic bullous keratopathy.

In donor grafts for patients with corneal endothelial dysfunction of various types, the removal of a circular area of the cornea (trephination) from donor tissue at the periphery rather than the center during DMEK appears to preserve more endothelial cells over time.

Video accompanying the EyeRounds Tutorial "Corneal Transplantation: From Donor to Recipient" http://eyerounds.org/tutorials/cornea-transplant-donor-to-recipient

A patient referred for penetrating keratoplasty instead underwent repeat DMEK with anterior lamellar keratectomy after anterior segment OCT suggested that a dense corneal opacity was a separable…

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