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Large-diameter Descemet membrane endothelial keratoplasty in buphthalmic eyes

Session Details

Session Title: Cornea

Session Date/Time: Sunday 17/02/2013 | 08:30-11:00

Paper Time: 10:10

Venue: Hall 2

First Author: : M.Rodriguez Calvo de Mora THE NETHERLANDS

Co Author(s): :    R. Quilendrino   R. Yeh   I. Dapena   L. Ham   M. Dirisamer   G. Melles

Abstract Details


To report the outcomes of Descemet membrane endothelial keratoplasty (DMEK) using a large-diameter graft in the management of endothelial decompensation in buphthalmic eyes.


Tertiary referral center.


Four eyes of four adults (one male, three females) with bullous keratopathy and buphthalmos secondary to congenital glaucoma were treated with DMEK using posterior lamellar grafts with diameters ranging from 10 to 12 mm. The mean age was 31 (+/- 9) years (range, 20 to 38 years). Mean follow-up time was 13.5 (+/- 7.5) months (range, 6 to 24 months). Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, endothelial cell density (ECD) and complications after surgery.


In all eyes, there was improved corneal clarity with decrease in pachymetry. The final postoperative BCVA improved in most eyes. There was no significant change in IOP, with three eyes needing additional anti-glaucoma medication. ECD loss ranged from 37 to 42%. Postoperative complications were early partial graft detachment in two eyes, one resolving spontaneously without intervention and the other requiring a re-bubbling, and cataract formation requiring phacoemulsification in one eye.


DMEK using a large or even full-diameter DM graft may be an effective treatment for bullous keratopathy in buphthalmic eyes. Partial graft detachment after surgery may be the main complication. Postoperative IOP control is mandatory, and BCVA may vary with ocular co-morbidity unrelated to the transplanted cornea.

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