Relationship Between Tissue Unscrolling Time and Endothelial Cell Loss.
Cornea
; 35(4): 471-6, 2016 Apr.
Article
en En
| MEDLINE
| ID: mdl-26845314
ABSTRACT
PURPOSE:
To assess the relationship between intraoperative unscrolling time of the donor Descemet membrane endothelial keratoplasty (DMEK) tissue and 6-month postoperative endothelial cell loss (ECL), and to determine whether donor age, scroll tightness, and the presence of an S stamp are related to unscrolling time.METHODS:
Ninety-three consecutive uncomplicated DMEK surgeries performed on eyes with Fuchs endothelial dystrophy using our standardized technique (ie, prestripped tissue with or without a premarked S stamp from our eye bank, overstripping the recipient, Straiko glass injector, no-touch tap technique, and bubble of 20% SF6 gas) were evaluated. Intraoperative unscrolling times and 6-month endothelial cell densities were measured and analyzed.RESULTS:
Sixty-nine cases comprised the study cohort. The median unscrolling time was 4 minutes (range 0.8-17.5 minutes), and the median ECL was 26.9% (range -4.3% to 80.0%). There was no relationship between unscrolling time and ECL at 6 months by the Pearson correlation coefficient (r = -0.02, P = 0.89). Younger donor age, tighter scrolls, and absence of an S stamp had no correlation with longer unscrolling times (all P > 0.05). Only 2 of 4 cases of iatrogenic primary graft failure had unscrolling times available for analysis; in this limited sample, there was no association between iatrogenic primary graft failure and unscrolling time.CONCLUSIONS:
Once the DMEK tissue is safely in the anterior chamber, surgeons need not rush the "DMEK dance" because longer unscrolling times may not endanger the endothelium.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Donantes de Tejidos
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Endotelio Corneal
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Distrofia Endotelial de Fuchs
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Pérdida de Celulas Endoteliales de la Córnea
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Queratoplastia Endotelial de la Lámina Limitante Posterior
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Tempo Operativo
Tipo de estudio:
Diagnostic_studies
Límite:
Adult
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Aged
/
Aged80
/
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cornea
Año:
2016
Tipo del documento:
Article