Influence Of Interface Fluid Between Recipient Cornea And Descemet Membrane Endothelial Keratoplasty Graft On The Rebubbling Rate
Published 2026 - 44th Congress of the ESCRS
Reference: PP11.12 | Type: Free paper | DOI: 10.82333/ts30-s185
Authors: Mr Lars Mackenbrock* 1 , Hyeck-Soo Son 2 , Maximilian Friedrich 2 , An Ting Xu 3 , Tadas Naujokaitis 3 , Julia Keim 2 , Ramin Khoramnia 3 , Gerd Auffarth 2 , Victor Augustin 2
1Department of Ophthalmology,University Hospital Dresden,Dresden,Germany;Department of Ophthalmology,University Hospital Heidelberg,Heidelberg,Germany, 2Department of Ophthalmology,University Hospital Heidelberg,Heidelberg,Germany, 3Department of Ophthalmology,University Hospital Dresden,Dresden,Germany
Purpose
To assess the presence of interface fluid at the end of Descemet membrane endothelial keratoplasty (DMEK) and to analyze the impact of this interface fluid on the postoperative graft detachment rate.
Setting
Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
Methods
At the end of DMEK after clinically satisfactory graft adhesion und complete air tamponade, corneas were imaged intraoperatively using optical coherence tomography (OCT). The number of interface fluid zones was counted using a custom-written computer script. These zones were classified according to their size (small or large) as well as to their location (graft center or periphery). The rebubbling rate for each patient was recorded.
Results
A total of 69 eyes of 69 patients undergoing DMEK surgery were included in this analysis. There was a considerable difference in the number of graft detachment between the patients, with a mean of 2.19 ± 1.94 for small central, 2.97 ± 3.11 for small peripheral, 0.51 ± 0.90 for large central and 0.81 ± 1.35 for large peripheral interface fluid collection areas per eye. 55 patients required no rebubbling, while 10 patients required 1, 3 patients required 2, and 1 patient required 3 rebubblings. A statistically significant correlation was observed between the number of large peripheral detachments and the rebubbling rate (r=0.368 with p=0.002).
Conclusions
Patients with incomplete graft attachment at the end of DMEK surgery have a higher risk for postoperative rebubbling. Corneal surgeons might detect these detachments using intraoperative OCT and modify their surgical technique to reduce them. Further, curvature matching between the host and the recipient might decrease the occurrence of interface fluid accumulation.