To assess the outcomes of Descemet membrane endothelial keratoplasty (DMEK) in patients with ocular hypotony following glaucoma surgery.
retrospective case series.
SETTING: Multicenter retrospective case series. PATIENTSINTERVENTION: Hypotonic eyes with prior glaucoma surgery which underwent DMEK between January 2013 and July 2019 in in Israel (two centers) and Canada (one center).
Pre/postoperative corrected distance visual acuity (CDVA), complications, 3-6-month endothelial cell loss, and intraocular pressure (IOP).
The study included 11 DMEK procedures performed in 10 eyes of 4 males and 6 females aged 65-84 years. Indications for DMEK included 7 cases of pseudophakic bullous keratopathy, two cases of failed DMEK and one case of failed DSAEK. All patients had at least one previous trabeculectomy operation. One patient had two trabeculectomy procedures and one tube placement procedure. Two patients had one previous trabeculectomy and one tube placement procedure. The CDVA improved significantly from 1.52±0.68 logMAR preoperatively to 0.49±0.32 logMAR three months postoperatively (p<0.001). Rebubbling occurred in 3/11 procedures (27%). Endothelial cell loss 6-12 months postoperatively was 60%±16 (range 41-89%). At last follow up visit, 6/11 (54%) of the grafts were clear. The remaining five grafts failed at 1 to 4 years postoperatively. Preoperative IOP was 5.1±1.6mmHg (range 1-7mmHg). In all but one patient, postoperative IOP did not increase to more than 13mmHg. In two cases, IOP decreased from 5 and 7mmHg preoperatively, to 1mmHg one year postoperatively.
DMEK is a valid procedure for the treatment of corneal edema in hypotonic eyes following glaucoma procedures. These eyes benefit from improvement in vision post DMEK.

Copyright © 2021. Published by Elsevier Inc.

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