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Outcomes of secondary penetrating keratoplasty graft failure managed by Descemet's membrane endothelial keratoplasty

Poster Details

First Author: N.Cesario Pereira BRAZIL

Co Author(s):    A. dos Santos Forseto   M. Wong   H. Delloiagono   J. Pereira Gomes           

Abstract Details


To describe the clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed for secondary graft failure after penetrating keratoplasty (PK) by an experienced DMEK surgeon.


Sorocaba Eye Bank / Sorocaba Ophthalmology Hospital.


Retrospective study, including 47 eyes of 42 patients undergoing DMEK after a secondary PK graft failure by a single surgeon (N.C.P) from July 2014 to July 2017 at Sorocaba Eye Bank /Sorocaba Ophthalmology Hospital. A combined procedure was performed in 8 patients with associated cataract. There were 16 eyes with associated ocular conditions as tubes, fixated intraocular lenses or were vitrectomized. Best-spectacle corrected visual acuity (BSCVA), biomicroscopy, previous eyes diseases and complications were evaluated.


There were no intraoperative complications. Graft detachment occurred in two eyes (4.2%) with preexisting tube from glaucoma-draining device, and were successfully managed with rebubbling. Two eyes with preexisting tube had late secondary graft failure (at 1 and 3 years after DMEK). One patient developed graft rejection at 4 months postoperatively and evolved to secondary graft failure. At the last follow-up, excluding eyes with low visual potential, 88.5% achieved BSCVA of 20/40 or better, 73% 20/30 or better, 38.4% 20/25 or better and 19.2% 20/20 or better. There were 3 eyes (11.5%) that needed rigid contact lenses for visual rehabilitation.


DMEK is a great option to manage secondary graft failure after PK in selected cases, with fast visual rehabilitation and reduced risk of intraoperative complications. Visual rehabilitation can be limited due to associated retinal conditions and irregular corneas. Rebubbling rate was low and associated to preexisting tubes from glaucoma-draining devices.

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