Universität zu Köln

Hayashi, Takahiko and Siebelmann, Sebastian (2022). Rescue Technique to Solve Postoperative Refractory Double Anterior Chamber in Deep Anterior Lamellar Keratoplasty. Cornea, 41 (3). S. 374 - 379. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose: The purpose of this study was to describe a simple rescue technique to solve postoperative double anterior chamber refractory to rebubbling in deep anterior lamellar keratoplasty (DALK). Methods: This study analyzed consecutive patients who underwent DALK between June 2014 and March 2018 and required a postoperative reattachment of Descemet membrane because of macroperforation-led persistent double chambers. The technique entails placing anchoring sutures to attach Descemet membrane to the donor's posterior stroma. Anchoring sutures were removed within 1 month of surgery. The postoperative best spectacle-corrected visual acuity (BSCVA) [converted to logarithm of the minimum angle of resolution (logMAR) units], endothelial cell density (cells/mm(2)), graft survival, postoperative complications, and corneal astigmatism (diopters) were evaluated. Results: Five eyes from 5 patients were included in this study [5 women, 63.6 +/- 6.0 yrs (32-80 yrs); mean follow-up duration, 72.0 +/- 23.3 mo (30-100 mo)] (mean +/- SD). The grafts survived successfully in all patients without primary or secondary graft failure. The best spectacle-corrected visual acuity improved from 1.26 +/- 0.66 logMAR preoperatively to 0.25 +/- 0.15 logMAR postoperatively (n = 5, P = 0.042). The endothelial cell density was 1468 +/- 810 cells/mm(2) at the last visit. Conclusions: Macroperforation of Descemet membrane during DALK with incomplete removal of the stroma can lead to persistent double anterior chamber. This complication could be solved by the technique devised by this study.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hayashi, Takahiko UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-673439
DOI:	10.1097/ICO.0000000000002953
Journal or Publication Title:	Cornea
Volume:	41
Number:	3
Page Range:	S. 374 - 379
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DESCEMETS-MEMBRANE PERFORATION; OUTCOMES Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67343