Effectiveness of External Device for Bubble Management in DMEK Surgery
Narrative Responses:
Purpose
To evaluate the utility of an external positioning device to help in the management of an anterior chamber bubble in DMEK surgery.
Methods
A retrospective chart review was conducted on eyes that had undergone DMEK surgery with a positioning device. Post-op 6, 12 and 18 month specular microscopy, pachymetry, anterior segment optical coherence tomography, and visual acuity were assessed.
Results
The device was useful in targeting positioning of intraocular bubbles to aid adhesion of grafts to areas adjacent dehisced edges. It was especially helpful with floppy iris syndrome, miosis and preventing iris-corneal touch in 2 cases. This was relieved with hyper-extended neck position and a bubble opposed to the inferior limbus; a head position which could only be supported comfortably by the device. Overall, the device helped with patient compliance with face-up head positioning post-DMEK. At 12 mo, avg. cell count was 1830 cells/mm +/- 615 (SD), avg pachy: 513um (43um SD) and avg. BSCVa was 0.28 logMAR.
Conclusion
The positioning device was useful in helping target areas for graft adhesion, preventing PAS and minimizing the risk of angle closure by affecting the position of the intraocular bubble in DMEK surgery. Post-op results were similar to that previously reported. This may be a useful adjunct device for DMEK surgery.