Descemet membrane endothelial keratoplasty and glaucoma

Area of Science:

• Ophthalmology
• Corneal Surgery
• Glaucoma Management

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is an advanced endothelial keratoplasty technique.
• Glaucoma is a potential complication following DMEK, impacting graft survival and vision.
• Understanding the interplay between DMEK and glaucoma is vital for patient care.

Purpose of the Study:

• To elucidate the relationship between Descemet membrane endothelial keratoplasty (DMEK) and glaucoma.
• To review the mechanisms, risks, and management strategies for glaucoma after DMEK.

Main Methods:

• Literature review focusing on studies investigating glaucoma following DMEK.
• Analysis of intraocular pressure (IOP) dynamics and contributing factors post-DMEK.
• Evaluation of pre-existing glaucoma impact on DMEK prognosis.

Main Results:

• Glaucoma post-DMEK can lead to irreversible vision loss and compromise graft survival.
• Mechanisms for elevated IOP include early postoperative reverse pupillary block and late steroid response.
• Eyes with pre-existing glaucoma may experience poorer outcomes after DMEK.

Conclusions:

• Prompt identification and treatment of elevated IOP are essential after DMEK.
• Accurate IOP measurement can be challenging due to air bubbles, edema, and corneal irregularities.
• Prophylactic iridectomy and specific steroid management protocols can mitigate risks.