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Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

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Iris Fixation via External Pentagram Suturing

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Peripheral Iridotomy-Less Approach in Descemet's Membrane Endothelial Keratoplasty Using Pupil-Dilating Eye Drops, a

Tarek Bayyoud¹, Karl Ulrich Bartz-Schmidt¹, Martin Rohrbach¹

¹Department of Ophthalmology, University Hospital of Tübingen, Tübingen, 72076, Germany.

Clinical Ophthalmology (Auckland, N.Z.)

|April 21, 2025

Summary

This summary is machine-generated.

Descemet Membrane Endothelial Keratoplasty (DMEK) without peripheral iridotomy (PI-less) shows promising outcomes. PI-less triple DMEK may enhance accessibility and reduce costs, but close intraocular pressure (IOP) monitoring is recommended.

Keywords:

DMEK PI-less descemet membrane endothelial keratoplasty no peripheral iridotomy pupil-dilating eye drops

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Area of Science:

Ophthalmology
Corneal Surgery
Endothelial Keratoplasty

Background:

Descemet Membrane Endothelial Keratoplasty (DMEK) is a surgical procedure for endothelial dysfunction.
Peripheral iridotomy (PI) is often performed with DMEK to prevent pupillary block.
The use of mydriatic eye drops post-DMEK without PI warrants investigation for safety and efficacy.

Purpose of the Study:

To assess clinical outcomes, specifically intraocular pressure (IOP) changes and graft viability, after PI-less DMEK using mydriatic eye drops.
To evaluate the safety and effectiveness of PI-less DMEK in patients with Fuchs' endothelial corneal dystrophy (FECD) and bullous keratopathy (BK).

Main Methods:

A retrospective, observational clinical study included 41 patients (44 eyes) undergoing PI-less DMEK.
Patients received either standard PI-less DMEK or PI-less triple DMEK, with mydriatic eye drops (phenylephrine and tropicamide) postoperatively.
Outcomes measured included best-corrected visual acuity (BCVA), endothelial cell density (ECD), and IOP, with a mean follow-up of 16 months.

Main Results:

Significant improvements in BCVA were observed in both PI-less DMEK groups.
Endothelial cell density showed a significant decrease postoperatively in both groups.
Intraocular pressure decreased significantly after postoperative day 1, with no significant intergroup differences after 6 months.

Conclusions:

PI-less DMEK with mydriatic eye drops demonstrates promising results regarding IOP and graft viability.
PI-less triple DMEK may offer advantages in terms of accessibility and cost-effectiveness, particularly in resource-limited settings.
Close postoperative IOP monitoring is advised for patients undergoing PI-less DMEK.