Rebubbling and Graft Detachment in Pre-Descemet Endothelial Keratoplasty: A Prospective Study
Amar Agarwal, Dhivya A. Kumar, Priya Narang, Soosan Jacob, Preethi Naveen, Ashvin Agarwal, Rhea NarangPurpose:
To report the graft detachment and rebubbling rate of pre-Descemet endothelial keratoplasty (PDEK) in patients with Fuch dystrophy and pseudophakic bullous keratopathy.
Methods:
In this prospective interventional study of 131 eyes (131 patients), the main-outcome measures were visual acuity, graft detachment and rebubbling rate, pachymetry, and endothelial cell count (ECD) loss.
Results:
The mean age of graft recipients was 64.5 ± 12.3 years(range 21–87 years); the mean donor age was 25.1 ± 8.7 years(range 10–70 years); and mean graft size was 7.5 ± 0.4 mm. Four eyes (3%) experienced partial graft detachment. Inferotemporal detachment was detected in 2 eyes, inferior in 1 eye, and central detachment in 1 eye. Two cases with graft detachment had no air bubble in the anterior chamber and 2 cases had less than 20% air in anterior chamber on the first postoperative day (POD). The graft detachment was detected on first POD in 2 cases, on second POD in 1 case and on third POD in 1 case. The mean ECD loss was 22.3%, whereas the ECD loss for eyes that underwent rebubbling was 24.8%. There was significant improvement in visual acuity (
Conclusions:
PDEK offers satisfactory visual outcomes and has a favorable complication profile with lower rate of graft detachment and rebubbling rate of 3%.