No association found between DMEK graft adhesion and initial IOP
German researchers analyzed the role of initial intraoperative IOP in Descemet’s membrane endothelial keratoplasty and found no evidence that higher IOP enhances graft adhesion.
Fifty-four eyes of 54 patients undergoing DMEK or DMEK combined with phacoemulsification were included in the retrospective, observational, single-center case series.
Based on previous work that suggested graft detachment may result from “insufficient support by the air bubble,” the study authors hypothesized that “a primarily higher IOP in the presence of the air bubble could lead to stronger pressure of the graft against the posterior stroma.”
In the study, complete graft adhesion was seen at the 1-week follow-up in 43 of the 54 eyes (79.6%). However, there were no statistically significant differences between complete and incomplete graft adhesions with regard to initial intraoperative IOP as measured by Schiötz tonometry.
“This study suggests that there is no correlation between initial IOP during DMEK surgery and graft adhesion after DMEK. Further studies with larger groups are needed to investigate the role of IOP in graft adhesion. It is crucial to further analyze the adhesion properties of the DMEK graft and to come up with strategies that enhance graft
adhesion and reduce rebubbling rates after DMEK,” the researchers wrote. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.