Wound Healing of Descemet Membrane After Penetrating Keratoplasty and Its Relevance for Descemet Membrane Endothelial Keratoplasty Surgeons.
Cornea
; 40(7): 910-913, 2021 Jul 01.
Article
en En
| MEDLINE
| ID: mdl-33591039
ABSTRACT
ABSTRACT Compared with penetrating keratoplasty (PK), Descemet membrane endothelial keratoplasty (DMEK) is characterized as lower risk for complications such as immunological graft reaction and faster and better postoperative visual recovery. In patients with endothelial graft failure after PK, DMEK can be used to regenerate PK graft transparency. The surgical technique for DMEK in this specific situation is still under debate, particularly regarding stripping of Descemet membrane (DM) from the failed PK and diameter of the DMEK graft. Here we report a case of a 75-year-old female patient with a failed graft 16 years after PK for Fuchs endothelial dystrophy, who underwent uneventful DMEK surgery. Stripping of DM in this particular case was performed outside the failed PK and demonstrated a biomechanically stable junction between the PK donor and the host DM. Histopathologic analysis of the excised DM showed continuous extracellular matrix connecting the host and donor DM, indicating primary intention wound healing after PK at this tissue level. This case demonstrates that after PK, a biomechanically stable and histologically continuous DM can enable Descemetorhexis outside the failed graft and transplantation of a DMEK graft larger than the previous PK. This may provide more endothelial cells for transplantation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cicatrización de Heridas
/
Distrofia Endotelial de Fuchs
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Queratoplastia Penetrante
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Lámina Limitante Posterior
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Queratoplastia Endotelial de la Lámina Limitante Posterior
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Cornea
Año:
2021
Tipo del documento:
Article