Klin Monbl Augenheilkd 2024; 241(06): 741-743
DOI: 10.1055/a-2089-3588
Der interessante Fall

Descemet Membrane Endothelial Keratoplasty in Eyes with an Artificial Iris

Descemet Membrane Endothelial Keratoplasty in Augen mit künstlicher Iris
Eye Center, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Thomas Reinhard
Eye Center, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Philip Christian Maier
Eye Center, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
› Author Affiliations

Abstract

The purpose of this study is to report the outcome of Descemet membrane endothelial keratoplasty (DMEK) in three eyes with a complex anterior segment and an artificial iris. A retrospective chart review of three cases was performed and clinically meaningful patient characteristics, clinical events, and therapeutic interventions were outlined. A literature search was performed and the clinical course of the three cases was discussed in the context of the published literature. DMEK in the presence of an artificial iris did not match the clinical results of DMEK in uncomplicated eyes. All three eyes experienced major complications, such as failure to achieve graft adherence, early graft failure, or an immune reaction. The indication for DMEK in complex anterior segments with an artificial iris should be made with the awareness of multiple possible complications and the potentially poor prognosis of the procedure.

Zusammenfassung

In dieser Fallserie wird über das Ergebnis der DMEK bei drei Augen mit einem komplexen vorderen Augenabschnitt und einer künstlichen Iris berichtet. Klinisch bedeutsame Patientencharakteristika und der klinische Verlauf inklusive therapeutischer Interventionen wurden beschrieben und vor dem Hintergrund der bereits zu diesem Thema publizierten Literatur diskutiert. Bei komplexem Vorderabschnitt mit Vorhandensein einer künstlichen Iris war die DMEK in den berichteten Fällen nicht nachhaltig erfolgreich. Bei allen drei Augen traten schwerwiegende Komplikationen auf, wie z. B. Dehiszenz des Transplantats, primäres Transplantatversagen oder eine Immunreaktion. Die Indikation zur DMEK bei komplexen vorderen Augenabschnitten mit einer künstlichen Iris sollte im Bewusstsein der möglichen Komplikationen und der potenziell reduzierten Prognose des Verfahrens gestellt werden.



Publication History

Received: 19 December 2022

Accepted: 11 April 2023

Article published online:
30 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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