Graft Detachment After Descemet's Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy

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Cardascia Nicola; Pastore Valentina; Bini Vito; Gabriella Lategola Maria; Alessio Giovanni

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Journal: MEDICAL HYPOTHESIS, DISCOVERY AND INNOVATION OPHTHALMOLOGY Year:2020 | Volume:9 | Issue:1 Page(s): 15-22

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Title

Graft Detachment After Descemet's Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy

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Keywords

DSAEK

Graft Detachment

Air Re-bubbling

Bullous Keratopathy

Fuchs Dystrophy

Abstract

Descemet’ s stripping automated endothelial keratoplasty (DSAEK) is a surgical technique for corneal transplantation in case of corneal decompensation. One of the main complications is Graft Detachment (GD) recoverable with Air Re-bubbling (ARB). The aim of this retrospective, interventional case series was to identify factors related to this complication in eyes operated for Bullous Keratopathy (BK) and Fuchs Dystrophy (FD). We considered one-hundred patients who underwent DSAEK for BK or FD between January 2016 and October 2017 at Department of Ophthalmology, Policlinico Universitario of Bari, Italy. Studied parameters included physiological and pathological anamnesis of both donors and recipients and properties of donor’ s lenticules and of the recipient’ s corneas. Data was analyzed using One-way ANOVA with Tukey post hoc test and Chi-square test with Odds Ratio (OR) calculation. We grouped patients according to diagnosis. GD occurred in 9 eyes affected by BK and 19 by FD (p=0. 003, OR = 0. 25, 95% CI, 0. 098-0. 62). It was recovered with ARB. In BK, ARB correlated to complicated cataract extraction (p=0. 04, OR = 7. 83, 95% CI, 1. 28 – 47. 98) and aphakia (p=0. 026, OR = 54. 38, 95% CI, 2. 51-11. 76). In FD, ARB was associated to donor’ s death for neoplasia (p=0. 06, OR= 4. 04, 95% CI, 1. 06 – 15. 37). No other differences were found. In conclusion, we could hypothesize that in FD patients, donor’ s cancer therapy may play a role on altered corneal fibroblast metabolism, activating a synergetic effect between chemotherapy and genetic alteration of FD, which may lead to an altered adhesion of donor’ s lenticule on recipient's stroma. In BK patients, complicated cataract extraction and aphakic status of recipients’ eye may contribute to altered adhesion of donor’ s lenticule post-DSAEK...

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APA: Copy

Cardascia, Nicola, Pastore, Valentina, Bini, Vito, Gabriella Lategola, Maria, & Alessio, Giovanni. (2020). Graft Detachment After Descemet's Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy. MEDICAL HYPOTHESIS, DISCOVERY AND INNOVATION OPHTHALMOLOGY, 9(1), 15-22. SID. https://sid.ir/paper/785448/en

Vancouver: Copy

Cardascia Nicola, Pastore Valentina, Bini Vito, Gabriella Lategola Maria, Alessio Giovanni. Graft Detachment After Descemet's Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy. MEDICAL HYPOTHESIS, DISCOVERY AND INNOVATION OPHTHALMOLOGY[Internet]. 2020;9(1):15-22. Available from: https://sid.ir/paper/785448/en

IEEE: Copy

Nicola Cardascia, Valentina Pastore, Vito Bini, Maria Gabriella Lategola, and Giovanni Alessio, “Graft Detachment After Descemet's Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy,” MEDICAL HYPOTHESIS, DISCOVERY AND INNOVATION OPHTHALMOLOGY, vol. 9, no. 1, pp. 15–22, 2020, [Online]. Available: https://sid.ir/paper/785448/en

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