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Postmortem evaluation of wound healing after Descemet's membrane endothelial keratoplasty (DMEK)

Poster Details

First Author: T.Müller THE NETHERLANDS

Co Author(s):    I. Lavy   R. Verdijk   M. Bruinsma   J. Parker   P. Binder   G. Melles     

Abstract Details

Purpose:

To describe the histologic features of postmortem eyes after Descemet membrane endothelial keratoplasty (DMEK) and their potential clinical implications.

Setting:

Netherlands Institute of Innovative Ocular Surgery

Methods:

Eleven postmortem corneas of eight patients, who underwent DMEK surgery for Fuchs endothelial dystrophy with an average postoperative time of 4 �Â�± 1.9 years were procured after death and processed for light microscopy evaluation.

Results:

Nine eyes showed a �â�€�˜normal�â�€�™ anatomy in the corneal center. One eye had an anatomically 'normal' periphery, ten showed peripheral abnormalities: in nine, the DMEK-graft overlapped with the host edge of the descemetorhexis; one eye showed a acellular scarring overlying a portion of the DMEK-graft that was detached followed by spontaneously adherence; three eyes showed graft folds with scar-tissue anteriorly; in two eyes (same patient), the anterior banded layer of the host DM was still in-situ across the cornea (both required re-bubbling); and two eyes showed host DM-remnants within the corneo-limbal tunnel incision that may have interfered with wound healing.

Conclusions:

Incomplete host DM removal may relate to postoperative DMEK graft detachment and wound instability. Graft detachments may re-attach with interface scarring. Re-bubbling procedures may be performed within 4-6 weeks, before scarring of detached graft portions occurs.

Financial Disclosure:

NONE

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