Format

Send to

Choose Destination
Indian J Ophthalmol. 2020 Jan;68(1):48-53. doi: 10.4103/ijo.IJO_1521_18.

Outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty or Descemet's stripping automated endothelial keratoplasty.

Author information

1
Academy for Eye Care Education; Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India.
2
Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India.
3
Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India.

Abstract

Purpose:

To study the outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty (DSEK) or Descemet's stripping automated endothelial keratoplasty (DSAEK).

Methods:

From 2260 eyes that underwent DSEK or DSAEK from July 2008 to June 2015, 80 eyes of 80 patients developed graft detachment and were retrospectively reviewed. Host-related, surgery-related and donor-related factors that have a bearing on graft adhesion were looked at retrospectively, and eventual outcomes after rebubbling procedure were studied.

Results:

Successful attachment was observed in 77 (96.25%) eyes and clear grafts were achieved in 55 (68.75%) eyes, while 25 (31.25%) eyes had graft failure. The uncorrected and best-corrected distance visual acuities significantly improved from 1 month to 3 months post-operatively and remained stable till 12 months of follow-up. Three lenticules that failed to attach with the first rebubbling procedure underwent a second rebubbling, two underwent a repeat DSEK with good outcomes and four underwent penetrating keratoplasty. On evaluating possible risk factors for graft failure, lower donor endothelial cell density was found to be a significant factor (P = 0.03). The median graft survival following rebubbling was 30 months.

Conclusion:

Rebubbling procedure in detached grafts after DSEK or DSAEK can reattach the lenticule in 96% of eyes in immediate post-operative period and the majority of the grafts remained clear on long-term follow-up with a median graft survival period of 2.5 years.

KEYWORDS:

Descemet's stripping automated endothelial keratoplasty; Descemet's stripping endothelial keratoplasty; endothelial cell density; graft detachment; rebubbling; retrospective

Supplemental Content

Full text links

Icon for Medknow Publications and Media Pvt Ltd Icon for PubMed Central
Loading ...
Support Center