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DMEK for the treatment of interface fluid syndrome secondary to failed DSAEK graft: a case report and review of the literature

2022-07Journal article Open access
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dc.contributor.authorMoura-Coelho, Nuno
dc.contributor.authorArrondo, Elena
dc.contributor.authorPapa-Vettorazzi, Mario Renato
dc.contributor.authorCunha, João Paulo
dc.contributor.authorGüell, José Luis
dc.date.accessioned2022-07-26T16:57:16Z
dc.date.available2022-07-26T16:57:16Z
dc.date.issued2022-07
dc.description.abstractPurpose: To report a case of Descemet membrane endothelial keratoplasty (DMEK) for the management of post-laser in situ keratomileusis (LASIK) interface fluid syndrome (IFS) secondary to failed Descemet stripping automated endothelial keratoplasty (DSAEK) graft, and to provide a literature review on endothelial keratoplasty (EK) for this indication. Observations: A 52-year-old patient presented with LASIK interface fluid accumulation and a non-functioning primary DSAEK graft. Past ophthalmic history was relevant for: (1) phakic intraocular lens (PIOL) implantation with later refinement by LASIK; (2) combined PIOL explantation and refractive lens exchange due to accelerated endothelial cell loss (ECL); (3) primary DSAEK due to corneal decompensation. A secondary EK graft (DMEK) was performed, and the patient was prospectively followed for 6 months (M6). DMEK surgery was uneventful, without postoperative graft detachment. Corneal clearing and resolution of interface fluid accumulation occurred during the first postoperative month. Best-corrected visual acuity (BCVA) improved from 20/800 Snellen to 20/25 Snellen at a 3-month follow-up, remaining stable at M6. Due to a persistent rise in intraocular pressure (IOP), the patient underwent an uneventful non-penetrating deep sclerectomy 2 months after DMEK, with controlled IOP, and without accelerated ECL. Conclusions and importance: DMEK is feasible, effective, and safe in the management of IFS in cases where corneal endothelial failure plays a major role, even in complex eyes with previous EK grafts. Aggressive postoperative IOP control is warranted to decrease the risk of interface fluid recurrence and damage to the optic nerve. Studies with larger patient numbers are encouraged to ascertain the role of EK in this indication.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMoura-Coelho N, Arrondo E, Papa-Vettorazzi MR, Cunha JP, Güell JL. DMEK for the treatment of interface fluid syndrome secondary to failed DSAEK graft: a case report and review of the literature. Am J Ophthalmol Case Rep. 2022;27:101656.pt_PT
dc.identifier.doi10.1016/j.ajoc.2022.101656pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/14883
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S2451993622004029pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectOphthalmologypt_PT
dc.subjectDescemet membrane endothelial keratoplastypt_PT
dc.subjectDMEKpt_PT
dc.subjectEndothelial keratoplastypt_PT
dc.subjectIntraocular pressurept_PT
dc.subjectInterface fluid syndromept_PT
dc.subjectLASIKpt_PT
dc.subjectLASER in situ keratomileusispt_PT
dc.titleDMEK for the treatment of interface fluid syndrome secondary to failed DSAEK graft: a case report and review of the literaturept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage101656pt_PT
oaire.citation.titleAmerican Journal of Ophthalmology Case Reportspt_PT
oaire.citation.volume27pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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