Rebubbling and graft failure in Descemet membrane endothelial keratoplasty: a prospective Dutch registry study

Author:

Dunker SuryanORCID,Winkens Bjorn,van den Biggelaar Frank,Nuijts Rudy,Kruit Pieter Jan,Dickman Mor

Abstract

AimsTo identify risk factors for rebubbling, and early graft failure after Descemet membrane endothelial keratoplasty (DMEK).MethodsIn this prospective registry study, all consecutive DMEK procedures registered in the Netherlands Organ Transplant Registry were assessed (n=752). Univariable and multivariable analysis was performed using logistic regression. The effect of rebubbling on endothelial cell density was analysed using a linear mixed model.Results144 of 752 (19%) eyes underwent rebubbling. Rebubbling was successful in 101 eyes (70%). In eyes that underwent rebubbling, the graft failure rate was significantly higher than eyes that did not undergo rebubbling (30% vs 9%, respectively; OR: 4.28, 95% CI 2.72 to 6.73, p<0.001). In multivariable analysis, independent risk factors for rebubbling were surgical complication (OR: 2.28, 95% CI 1.20 to 4.33, p=0.012) and older recipient age (OR: 1.04 (per increase of 1 year), 95% CI 1.01 to 1.07, p=0.003). Risk factors for developing graft failure within 3 months were transplant before 2016 (OR: 3.32, 95% CI 1.87 to 5.90, p<0.001), and surgical complication (OR: 2.93, 95% CI 1.42 to 6.04, p=0.004). Throughout the study period, rebubbling and early graft failure were inversely related. Eyes that underwent rebubbling showed significantly lower endothelial cell densities at 3, 6 and 12 months compared with eyes that did not undergo rebubbling (all p<0.001).ConclusionsThis Dutch registry study identified independent risk factors for DMEK graft detachment leading to rebubbling, namely recipient age and surgical complication, and early graft failure, namely transplantation before 2016 and surgical complication. Rebubbling was associated with significantly higher endothelial cell loss in the first year after surgery.

Publisher

BMJ

Subject

Cellular and Molecular Neuroscience,Sensory Systems,Ophthalmology

Reference23 articles.

1. Eye Bank Association of America . Eye banking statistical report, 2018. Available: https://restoresight.org/wp-content/uploads/2019/03/2018_Statistical_Report-Complete-1.pdf [Accessed 02 Nov 2020].

2. Trends in corneal transplantation from 2001 to 2016 in Germany: a report of the DOG-Section cornea and its keratoplasty registry;Flockerzi;Am J Ophthalmol,2018

3. Descemet membrane endothelial keratoplasty: safety and outcomes: a report by the American Academy of ophthalmology;Deng;Ophthalmology,2018

4. Association between graft storage time and donor age with endothelial cell density and graft adherence after Descemet membrane endothelial keratoplasty;Rodríguez-Calvo de Mora;JAMA Ophthalmol,2016

5. Influences on rebubble rate in Descemet's membrane endothelial keratoplasty;Mechels;Clin Ophthalmol,2017

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