Universität zu Köln

Bachmann, Bjoern O., Schrittenlocher, Silvia A., Schaub, Friederike, Siebelmann, Sebastian, Matthaei, Mario and Cursiefen, Claus (2017). Complications of DMEKeratoplasty: Avoid, Recognize and Treat. Klinische Monatsblat. Augenheilkunde, 234 (11). S. 1354 - 1362. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-3999

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Abstract

Descemet membrane endothelial keratoplasty (DMEK) has evolved into a routine surgical procedure for posterior lamellar keratoplasty. After its introduction more than 10 years ago, several modifications in grafting technique and postoperative treatment regimen helped to improve its safety and reproducibility. Although DMEK offers faster and better improvements in visual acuity, as well as less graft rejections when compared to Descemet's stripping (automated) endothelial keratoplasty (DS[A]EK), difficulties when implementing this technique hamper the widespread use in many areas. However, different strategies help to reduce the rate of intra-and postoperative complications, making DMEK the method of choice for most patients with corneal endothelial diseases. Certain techniques help to reduce the endothelial damage during graft preparation; correct matching of donor age and recipient's anterior chamber depth eases intracameral unfolding of the DMEK graft, the use of SF6 gas for anterior chamber tamponade reduces the need for additional rebubblings, and the correct frequency and duration of postoperative topical steroid treatment helps to reduce the development of cystoid macular edema and graft rejections. Further standardization, but also individualization, of DMEK helps to offer this treatment option to patients with more complex anterior segment situations like anterior synechia, larger iris defects and glaucoma drainage devices.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bachmann, Bjoern O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrittenlocher, Silvia A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaub, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-211932
DOI:	10.1055/s-0043-105269
Journal or Publication Title:	Klinische Monatsblat. Augenheilkunde
Volume:	234
Number:	11
Page Range:	S. 1354 - 1362
Date:	2017
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-3999
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEMBRANE ENDOTHELIAL KERATOPLASTY; PREDNISOLONE ACETATE 1-PERCENT; DESCEMET MEMBRANE; IMMUNE-REACTIONS; RISK; BLUE Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21193