Safety and clinical outcomes of omitting same and next day review after DMEK performed with an inferior peripheral iridotomy

Eye (Lond). 2023 Nov;37(16):3492-3495. doi: 10.1038/s41433-023-02542-8. Epub 2023 Apr 25.

Abstract

Background/objectives: To determine the incidence of day one postoperative complications after Descemet Membrane Endothelial Keratoplasty (DMEK) performed with intraoperative inferior peripheral iridotomy (PI), and whether their early detection influences postoperative intervention.

Subjects/methods: 70 eyes of 70 consecutive patients that underwent DMEK from August 2019 to August 2021 at a single UK centre were retrospectively analysed. Cases that did not have an inferior PI were excluded. Any action taken at day one and week one postoperative review was noted.

Results: No pupil block or other major adverse events were found at day one review. At one week, 14 eyes (20%) required re-bubbling, all of which had been fully attached at the day one review.

Conclusions: This series suggests that inferior PI performed alongside DMEK alone or triple DMEK effectively minimizes the risk of pupil block. Since no early complications occurred in this cohort requiring immediate intervention, it may be safe to defer review of these patients to a later time point.

MeSH terms

  • Cell Count
  • Descemet Membrane / surgery
  • Descemet Stripping Endothelial Keratoplasty* / adverse effects
  • Endothelium, Corneal
  • Fuchs' Endothelial Dystrophy* / surgery
  • Humans
  • Retrospective Studies
  • Visual Acuity