Universität zu Köln

Bucher, Franziska, Hos, Deniz, Mueller-Schwefe, Stephan, Steven, Philipp, Cursiefen, Claus and Heindl, Ludwig M. (2015). Spontaneous long-term course of persistent peripheral graft detachments after Descemet's membrane endothelial keratoplasty. Br. J. Ophthalmol., 99 (6). S. 768 - 773. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2079

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Abstract

Background Peripheral corneal graft detachment after Descemet's membrane endothelial keratoplasty (DMEK) is a frequently occurring postoperative complication. The natural course of these persistent peripheral detachments over time is not known. Methods 166 patients were surveyed by slit-lamp-adapted optical coherence tomography (SL-OCT)directly after surgery, during first postoperative week, 4 weeks, 3, 6 and 12 months, postoperatively. Patients with a persistent peripheral graft detachment 4 weeks after DMEK (n= 16) were observed for their spontaneous course up to 1 year postoperatively. Results Persistent graft detachments could be characterised into two phenotypes: peripheral roll (n= 11; 69%) and laminar detachment (n= 5; 31%). Maximal length of the detachment did not change in peripheral rolls during observation period (12 months vs 4 weeks, 578 +/- 122 mu m vs 593 +/- 106 mu m, p= 0.74), whereas laminar detachments spontaneously attached to the host's stroma (12 months vs 4 weeks, 0 mu m vs 1088 +/- 295 mu m, p= 0.001). Central corneal thickness and (peripheral) corneal thickness above the detached area did not significantly change in either group. Conclusions Persistent peripheral graft detachments after DMEK occurred in 10% of patients and had two distinct OCT-phenotypes. Peripheral rolls did not change during the first 12 months, postoperatively. By contrast, peripheral laminar detachments attached spontaneously even months after surgery. Corneal thickness reduction was only observed above peripheral laminar detachment, but not above peripheral rolls.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bucher, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Hos, Deniz UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Schwefe, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-403005
DOI:	10.1136/bjophthalmol-2014-305562
Journal or Publication Title:	Br. J. Ophthalmol.
Volume:	99
Number:	6
Page Range:	S. 768 - 773
Date:	2015
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-2079
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPLIT CORNEA TRANSPLANTATION; OPTICAL COHERENCE TOMOGRAPHY; DMEK; COMPLICATIONS; PREVENTION; MANAGEMENT; DSAEK Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40300