Potential Causes of Incomplete Visual Rehabilitation at 6 Months Postoperative After Descemet Membrane Endothelial Keratoplasty

摘要: Purpose To determine the various causes of unexpected incomplete visual rehabilitation at 6 months postoperative after Descemet membrane endothelial keratoplasty (DMEK). Design Retrospective study prospectively collected data a tertiary referral center. Methods From larger group 400 consecutive DMEK surgeries, last 200 eyes were reviewed for discomfort despite best-corrected acuity (BCVA) ≥20/25 (≥0.8) or subnormal BCVA (≤20/28; ≤0.7) DMEK. Biomicroscopy, funduscopy, Pentacam imaging, noncontact specular microscopy, anterior segment optical coherence tomography, and surgical videos used to rehabilitation. Results A total 69 out 178 that included in analysis (38.8%) presented with incomplete visual DMEK, further categorized as "primarily patient-related" 40 (22.5%), graft-related" 21 (11.8%), combination "patient-/graft-related" 8 cases (4.5%). Unrecognized pre-existing ocular pathology and/or posterior disease 19 (10.7%), clinically significant corneal irregularities central scarring often secondary long-standing preoperative edema 14 (7.9%), (partial) graft detachment 20 (11.2%) main Transient persistent monocular ghost images diplopia occurred 10 (5.6%), sometimes requiring contact lens fitting. Conclusions In contrast earlier techniques may frequently be associated undefined transplant-related outcomes, virtually always explained by concomitant evident failure.