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One-year outcome after Descemet membrane endothelial keratoplasty (DMEK) comparing sulfur hexafluoride (SF6) 20% versus 100% air for anterior chamber tamponade
  1. Friederike Schaub,
  2. Philip Enders,
  3. Katharina Snijders,
  4. Silvia Schrittenlocher,
  5. Sebastian Siebelmann,
  6. Ludwig M Heindl,
  7. Björn O Bachmann,
  8. Claus Cursiefen
  1. Department of Ophthalmology, University of Cologne, Cologne, Germany
  1. Correspondence to Dr Friederike Schaub, Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, Cologne 50924, Germany; friederike.schaub{at}uk-koeln.de

Abstract

Purpose To investigate 1-year clinical outcome and complication rates following Descemet membrane endothelial keratoplasty (DMEK) with sulfur hexafluoride 20% (SF620%) anterior chamber tamponade compared with conventionally used 100% air for primary graft attachment during DMEK surgery.

Methods Records of 1112 consecutive DMEKs were reviewed retrospectively and grouped by anterior chamber tamponade used during DMEK surgery (SF620% vs 100% air). Outcome measures included intraocular pressure (IOP), best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD) and central corneal thickness (CCT) at 1, 3, 6 and 12 months after DMEK surgery. Complication rates were assessed, including intraoperative and postoperative complications, and graft detachment rate requiring rebubbling.

Results A total of 854 cases were included in this study. In 105 cases (12.3%), DMEK was performed with SF620%, and in 749 cases (87.7%) 100% air was used for anterior chamber tamponade. Outcome results for IOP, BSCVA, ECD and CCT at all follow-up time points were comparable for both anterior chamber tamponade groups without statistical significant differences (p≥0.05), but graft detachment rate requiring rebubbling was significantly lower in the SF620% group (p<0.001).

Conclusion Whereas SF620% anterior chamber tamponade does not seem to negatively affect the clinical outcome of DMEK surgery within the first postoperative year, use of SF620% significantly reduces the rate of rebubblings.

  • Cornea
  • Dystrophy

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Footnotes

  • Contributors Conception and design: FS and CC. Data collection, evaluation and analyses: FS, PE, KS, SS, SS, BOB and LMH. Preparation, review and approval of the manuscript: all authors.

  • Funding German Research Foundation FOR 2240 “(Lymph) Angiogenesis And Cellular Immunity in Inflammatory Diseases of the Eye” to CC and LMH (http://www.for2240.de), EU COST BM1302 “Joining Forces in Corneal Regeneration” to BB and CC (http://www.biocornea.eu).

  • Competing interests None declared.

  • Ethics approval The study was approved by the local Institutional Review Board (14–373) and was conducted in adherence to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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