Surgery-induced iris abnormalities after Descemet membrane endothelial keratoplasty and their impact on postoperative clinical outcomes

Figures & data

Table 1 Demographics of 32 eyes from 28 patients who underwent DMEK (or triple DMEK)

Total number of eyes	32
Age (years), mean ± SD	65.7±13.4
Sex (male: female)	14: 18
Indications of DMEK, number of eyes (%)
Fuchs endothelial dystrophy	13 (40.6%)
Endothelial dysfunction associated with laser iridotomy	12 (37.5%)
Pseudophakic bullous keratopathy	2 (6.3%)
Others	5 (15.6%)
Procedure (solitary DMEK: triple DMEK)	25: 7

Abbreviation: DMEK, Descemet membrane endothelial keratoplasty.

Figure 1 Representative cases with surgery-induced iris abnormalities after DMEK. (A) Case 1: a 69-year-old man had bullous keratopathy after cytomegalovirus corneal endotheliitis in his right eye. This eye was pseudophakic. (B) Case 1, after solitary DMEK, mild ovalization of the pupil (arrow), likely due to posterior synechiae, was noted. (C) Case 2: a 73-year-old woman had laser iridotomy-related bullous keratopathy in her right eye. This eye was pseudophakic. (D) Case 2, after solitary DMEK, mild iris depigmentation (arrows) was detected near the temporal wound.

Table 2 Comparison between Group A (with surgery-induced iris abnormalities) and Group B (without surgery-induced iris abnormalities)

	Group A (with surgery-induced iris abnormalities), n=15	Group B (without surgery-induced iris abnormalities), n=17	P-value*
Patient age (years), mean ± SD	68.3±8.9	66.6±9.8	0.60
Sex (male: female)	5: 10	9: 8	0.31
Indications of DMEK (Fuchs endothelial dystrophy: LIBK: others)	4: 7: 4	9: 5: 3	0.13
Procedure (solitary DMEK: triple DMEK)	13: 2	12: 5	0.40
Preoperative vision (LogMAR), mean ± SD	0.66±0.46	0.44±0.41	0.11
Six-month postoperative vision (LogMAR), mean ± SD	0.21±0.38	0.07±0.20	0.65
Donor age (years), mean ± SD	59.6±10.1	61.7±10.4	0.52
Preoperative donor ECD (cells/mm^2), mean ± SD	2790±246	2733±194	0.66
Six-month postoperative ECD (cells/mm^2), mean ± SD	1684±659	1673±553	0.70
One-year postoperative ECD (cells/mm^2), mean ± SD	1514±671	1434±576	0.87

Note: *Mann-Whitney U test.

Abbreviations: DMEK, Descemet membrane endothelial keratoplasty; LIBK, laser iridotomy-induced bullous keratopathy; ECD, endothelial cell density.