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BMJ Open Ophthalmol
BMJ Open Ophthalmol
bmjophth
bmjophth
BMJ Open Ophthalmology
2397-3269
BMJ Group BMA House, Tavistock Square, London, WC1H 9JR

37282677
bmjophth-2022-EEBA.32
10.1136/bmjophth-2022-EEBA.32
Oral abstracts
Theme 6 – Clinical outcome monitoring and transplantation registries
1506
32 Corneal guttae after descemet membrane endothelial keratoplasty (DMEK)
Groeneveld-van Beek Esther A 12
Vasanthananthan Kaemela 13
Lie Jessica T 12
Melles GerritRJ 123
van der Wees Jacqueline 12
Oellerich Silke 1
Kocaba Viridiana 123
1 Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
2 Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands
3 Melles Cornea Clinic, Rotterdam, The Netherlands
2022
16 11 2022
7 Suppl 2 Abstracts of the European Eye Bank Association Virtual Meeting, 3–5 March 2022 A13A14
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
2022
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

Purpose

To report on the occurrence of corneal guttae after Descemet membrane endothelial keratoplasty (DMEK) in eyes operated on for Fuchs endothelial corneal dystrophy (FECD).

Material and Methods

Case series of 10 eyes of 10 patients operated on for FECD at a tertiary referral center between 2008 and 2019. Average patient age was 61±12 years and 3 patients were female and 6 were male. Five patients were phakic and 4 pseudophakic. Average donor age was 67±9 years.

Results

During routine postoperative consultation, specular microscopy images showed suspected recurrence of guttae in 10 eyes after DMEK. Presence of guttae was subsequently confirmed in 9 cases by confocal microscopy and in one case by histology. Six out of 10 patients (60%) had undergone bilateral DMEK, but all only showed recurrence of guttae in one eye. In 9 eyes guttae recurred after primary DMEK, while in one eye recurrence was after a re-DMEK that has been performed 56 months after the first DMEK with no signs of guttae after primary DMEK. Suspected guttae were visible on specular microscopy images already at 1 month after DMEK in most cases.

No guttae had been noted during donor cornea processing in the eye bank. Preoperative donor endothelial cell density (ECD) had been 2643±145 cells/mm2 and 1-year postoperative ECD was 1047±458 cells/mm2 (n=8).

Conclusion

Recurrence of guttae after DMEK is most likely due to guttae on the donor graft that were not detectable by routine slit-lamp and light-microscopy evaluation in the eye bank. Better screening methods for guttae detection need to be developed for eye banks to avoid releasing tissue for transplantation that contains guttae or is prone for postoperative guttae formation.

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