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ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 1  |  Page : 48-53

Outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty or Descemet's stripping automated endothelial keratoplasty


1 Academy for Eye Care Education; Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
2 Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India
3 Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. Jagadesh C Reddy
Cornea and Anterior Segment Services, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad - 500 034, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1521_18

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Purpose: To study the outcomes of rebubbling for graft detachment after Descemet's stripping endothelial keratoplasty (DSEK) or Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods: From 2260 eyes that underwent DSEK or DSAEK from July 2008 to June 2015, 80 eyes of 80 patients developed graft detachment and were retrospectively reviewed. Host-related, surgery-related and donor-related factors that have a bearing on graft adhesion were looked at retrospectively, and eventual outcomes after rebubbling procedure were studied. Results: Successful attachment was observed in 77 (96.25%) eyes and clear grafts were achieved in 55 (68.75%) eyes, while 25 (31.25%) eyes had graft failure. The uncorrected and best-corrected distance visual acuities significantly improved from 1 month to 3 months post-operatively and remained stable till 12 months of follow-up. Three lenticules that failed to attach with the first rebubbling procedure underwent a second rebubbling, two underwent a repeat DSEK with good outcomes and four underwent penetrating keratoplasty. On evaluating possible risk factors for graft failure, lower donor endothelial cell density was found to be a significant factor (P = 0.03). The median graft survival following rebubbling was 30 months. Conclusion: Rebubbling procedure in detached grafts after DSEK or DSAEK can reattach the lenticule in 96% of eyes in immediate post-operative period and the majority of the grafts remained clear on long-term follow-up with a median graft survival period of 2.5 years.


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