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Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”)
PURPOSE: Despite faster healing and reduced risk of rejection, some surgeons are hesitant to adopt Descemet membrane endothelial keratoplasty (DMEK) due to difficult intraoperative tissue preparation. Use of eye bank prestripped, prestained, and preloaded (p(3)) DMEK tissue can reduce the learning c...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220431/ https://www.ncbi.nlm.nih.gov/pubmed/37252165 http://dx.doi.org/10.4103/tjo.TJO-D-22-00155 |
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author | Juratli, Lena Qureshi, Sana Liles, Nathan Hussain, Munira Hood, Christopher Mian, Shahzad I. |
author_facet | Juratli, Lena Qureshi, Sana Liles, Nathan Hussain, Munira Hood, Christopher Mian, Shahzad I. |
author_sort | Juratli, Lena |
collection | PubMed |
description | PURPOSE: Despite faster healing and reduced risk of rejection, some surgeons are hesitant to adopt Descemet membrane endothelial keratoplasty (DMEK) due to difficult intraoperative tissue preparation. Use of eye bank prestripped, prestained, and preloaded (p(3)) DMEK tissue can reduce the learning curve and risk of complications. MATERIALS AND METHODS: We conducted a prospective study including 167 eyes undergoing p(3) DMEK and compared outcomes to a retrospective chart review of 201 eyes that underwent standard DMEK surgery. The primary outcomes were graft failure, detachment, and re-bubbling frequency. The secondary outcomes included baseline and postoperative visual acuity at months 1, 3, 6, and 12. Baseline and postoperative central corneal thickness (CCT) and endothelial cell counts (ECC) were collected. RESULTS: ECC decrease for p(3) DMEK at 3, 6, and 12 months were 15.0%, 18.0%, and 21.0%, respectively. Forty (24%) of p(3) DMEK and 72 (35.8%) of standard DMEK eyes had at least a partial graft detachment. There was no difference in CCT, graft failures, or re-bubble frequency. At 6 months, mean visual acuity was 20/26 and 20/24 for standard and p(3) DMEK, respectively. Mean case time for p(3) DMEK with phaco or p(3) DMEK alone was 33 and 24 min, respectively. Mean case time for eyes undergoing DMEK with phaco or DMEK alone was 59 and 45 min, respectively. CONCLUSION: P(3) DMEK tissue is safe and can provide excellent clinical outcomes that are comparable to standard DMEK tissue. Eyes undergoing p(3) DMEK may have lower graft detachment and ECC loss. |
format | Online Article Text |
id | pubmed-10220431 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-102204312023-05-28 Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) Juratli, Lena Qureshi, Sana Liles, Nathan Hussain, Munira Hood, Christopher Mian, Shahzad I. Taiwan J Ophthalmol Original Article PURPOSE: Despite faster healing and reduced risk of rejection, some surgeons are hesitant to adopt Descemet membrane endothelial keratoplasty (DMEK) due to difficult intraoperative tissue preparation. Use of eye bank prestripped, prestained, and preloaded (p(3)) DMEK tissue can reduce the learning curve and risk of complications. MATERIALS AND METHODS: We conducted a prospective study including 167 eyes undergoing p(3) DMEK and compared outcomes to a retrospective chart review of 201 eyes that underwent standard DMEK surgery. The primary outcomes were graft failure, detachment, and re-bubbling frequency. The secondary outcomes included baseline and postoperative visual acuity at months 1, 3, 6, and 12. Baseline and postoperative central corneal thickness (CCT) and endothelial cell counts (ECC) were collected. RESULTS: ECC decrease for p(3) DMEK at 3, 6, and 12 months were 15.0%, 18.0%, and 21.0%, respectively. Forty (24%) of p(3) DMEK and 72 (35.8%) of standard DMEK eyes had at least a partial graft detachment. There was no difference in CCT, graft failures, or re-bubble frequency. At 6 months, mean visual acuity was 20/26 and 20/24 for standard and p(3) DMEK, respectively. Mean case time for p(3) DMEK with phaco or p(3) DMEK alone was 33 and 24 min, respectively. Mean case time for eyes undergoing DMEK with phaco or DMEK alone was 59 and 45 min, respectively. CONCLUSION: P(3) DMEK tissue is safe and can provide excellent clinical outcomes that are comparable to standard DMEK tissue. Eyes undergoing p(3) DMEK may have lower graft detachment and ECC loss. Wolters Kluwer - Medknow 2023-02-20 /pmc/articles/PMC10220431/ /pubmed/37252165 http://dx.doi.org/10.4103/tjo.TJO-D-22-00155 Text en Copyright: © 2023 Taiwan Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Juratli, Lena Qureshi, Sana Liles, Nathan Hussain, Munira Hood, Christopher Mian, Shahzad I. Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title | Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title_full | Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title_fullStr | Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title_full_unstemmed | Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title_short | Clinical outcomes of prestripped, prestained, and preloaded Descemet's membrane endothelial keratoplasty (“P3 DMEK”) |
title_sort | clinical outcomes of prestripped, prestained, and preloaded descemet's membrane endothelial keratoplasty (“p3 dmek”) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220431/ https://www.ncbi.nlm.nih.gov/pubmed/37252165 http://dx.doi.org/10.4103/tjo.TJO-D-22-00155 |
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