Repeat Descemet Membrane Endothelial Keratoplasty: Secondary Grafts with Early Intervention Are Comparable with Fellow-Eye Primary Grafts

摘要: Purpose To evaluate the outcomes of secondary Descemet membrane endothelial keratoplasty (DMEK) after failed primary DMEK. Design Retrospective, interventional case series. Participants Fifty-five DMEK recipients 42 to 89 years age. Methods An initial consecutive series 1655 surgeries was reviewed identify cases (n = 55). A paired fellow-eye analysis performed with a subgroup 29 patients who underwent in 1 eye and successful fellow eye. Main Outcome Measures Corrected distance visual acuity (CDVA), central corneal thickness, 1-year cell loss. Results The median follow-up regraft 18 months (range, 3–61 months). All 55 regrafts cleared, 8 (15%) had air reinjected promote attachment, (2%) trabeculectomy progressive synechiae demonstrated late failure, no rejection episodes occurred (0%). In analysis, duration decompensation before 21 days 2–133 days). At 1, 3, 6, or 12 months, CDVA did not differ between grafts eyes (mean difference, ≤2 Snellen letters; P > 0.05 at all examinations). year, ≥20/20 61%, ≥20/25 81%, ≥20/40 100% excluding retinal problems. Vision differed by ≤1 line but patient longest time (133 days), haze irregular astigmatism from anterior stromal scarring during that period. associated 20/40 versus 20/20 for graft. thickness comparable difference 2 μm;  = 0.57). loss (27% vs. 31%, respectively; 0.58). Conclusions received prompt intervention minimize decompensation, matched